Individual
MRS. AMANDA LEIGH WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A. CF-SLP
Contact information
Practice address
928 W MARKET ST, TIFFIN, OH 44883-2529
(419) 270-0041
Mailing address
10 CAROLINA DR, PERRYSBURG, OH 43551-3616
(419) 270-0041
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
COND. 2014271
OH
Other
Enumeration date
09/07/2014
Last updated
09/07/2014
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