Individual
CLAIRE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A. CCC-SLP
Contact information
Practice address
1940 BONITA DR, APTOS, CA 95003-5524
(831) 684-1804
Mailing address
1290 SHAFFER RD APT 9304, SANTA CRUZ, CA 95060-5780
(831) 247-9509
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
21452
CA
Other
Enumeration date
06/17/2014
Last updated
06/17/2014
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