Individual
ALYSSA WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. SLP
Contact information
Practice address
2350 ROUTE 63, WAYLAND, NY 14572-9509
(607) 765-1700
Mailing address
8864 WARNER RD, WAYLAND, NY 14572-9387
(607) 765-1700
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
024855
NY
Other
Enumeration date
07/21/2015
Last updated
04/18/2020
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