Individual
MS. APRIL REED WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
120 VETERANS DR, OXFORD, MS 38655-3578
(662) 232-8070
Mailing address
136 YOCONA RIDGE RD, OXFORD, MS 38655-6904
(662) 832-4086
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0000003185
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000003185
TN LISENCE TO PRACTICE
TN
01
—
S3237
STATE LICENSE
MS
Enumeration date
07/16/2008
Last updated
03/19/2011
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