Doctor Name: | MRS. JANE LAMBERT WALLACE |
NPI Number: | 1366602609 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., CCC-SLP |
License Number: | SP0000000552 |
Business Practice Address: | 2150 Wilma Rudolph Blvd Suite 2 Clarksville, TN - 370406675 |
Business Phone Number: | 9315422168 |
Business Fax Number: | |
Mailing Address: | 145 E Glenwood Dr, CLARKSVILLE |
State: | TN |
Postal Code: | 370403552 |
Phone Number: | 9315524413 |
Fax Number: | |
NPI Enumeration Date: | 06/10/2008 |
NPI Last Update Date: | 06/23/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP0000000552 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
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 |