Individual
ELLERY CAROLINE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
2427 RUSSELLVILLE RD, BOWLING GREEN, KY 42101-3980
(270) 936-7472
(317) 520-0820
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 324-0885
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
286690
KY
Other
Enumeration date
05/06/2019
Last updated
01/26/2024
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