Individual
BAILEE ANN WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
2500 N WALNUT CREEK DR, MANSFIELD, TX 76063-4287
(919) 424-5080
Mailing address
212 NE CINDY LN, BURLESON, TX 76028-3434
(214) 532-6154
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
118351
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
118351
AMERICAN SPEECH LANGUAGE HEARING ASSOCIATION LICENSE NUMBER
TX
Enumeration date
10/03/2022
Last updated
10/09/2024
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