Individual
MRS. ANGELLA MESHELLE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC/SLP
Contact information
Practice address
4000 S IH 35, AUSTIN, TX 78704-7420
(512) 414-1700
Mailing address
1001 SILBURY DR, AUSTIN, TX 78758-3936
(818) 667-0195
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
108141
TX
Other
Enumeration date
09/13/2021
Last updated
08/18/2022
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