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Individual

SAMANTHA WALLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S. CCC-SLP

Contact information

Practice address
100 CUMMINGS CTR, STE 135-H, BEVERLY, MA 01915-6115
(978) 927-0172
Mailing address
100 CUMMINGS CTR, STE 135-H, BEVERLY, MA 01915-6115

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9193
MA

Other

Enumeration date
06/03/2014
Last updated
06/29/2016
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