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ROBIN SUE WALLACE SLP

>> Speech-Language Pathologist >> Speech, Language and Hearing Service Providers

Registrant NPI Number: 1720755283

Individual Registrant:
 ROBIN SUE WALLACE SLP
Gender: F
Sole Proprietor

Location and contact information for practice:
17674 W HIGHWAY 32  LICKING, MO 65542-9018 US
Tel: 573-201-8534  Fax: --

Contact information for business:
17674 W HIGHWAY 32  LICKING, MO 65542-9018 US
Tel: 573-201-8534  Fax: --

Registration Information:
NPI: 1720755283
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y235Z00000XSpeech, Language and Hearing Service Providers
Speech-Language Pathologist
MO2021034135

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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