Individual
MRS. HANNAH WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED, M.S.
Contact information
Practice address
1079 ALEXIS AVE NE, CORYDON, IN 47112
(812) 596-0047
Mailing address
1079 ALEXIS AVE NE, CORYDON, IN 47112-8402
(812) 596-0047
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22005554A
IN
Other
Enumeration date
04/17/2013
Last updated
05/15/2018
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