Individual
ELLEN ANNE WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
3101 W CHARLESTON BLVD, LAS VEGAS, NV 89102-1931
(702) 831-6670
Mailing address
2200 LINDELL RD, LAS VEGAS, NV 89146-3304
(281) 995-4631
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
07/30/2020
Last updated
12/18/2023
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