| Doctor Name: | MARY M WALLY |
| NPI Number: | 1033272018 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SLP |
| License Number: | 100854 |
| Business Practice Address: | 1901 Dutton Dr San Marcos, TX - 786667573 |
| Business Phone Number: | 5128471547 |
| Business Fax Number: | |
| Mailing Address: | 819 Water St, Suite 300 KERRVILLE |
| State: | TX |
| Postal Code: | 780285333 |
| Phone Number: | 8307923300 |
| Fax Number: | 8307925771 |
| NPI Enumeration Date: | 12/19/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 100854 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |