| Doctor Name: | MRS. LAURA B WALLIS |
| NPI Number: | 1972978484 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S CCC/SLP |
| License Number: | 2079 |
| Business Practice Address: | 15325 S Lone Elm Rd Olathe, KS - 660615416 |
| Business Phone Number: | 9132067505 |
| Business Fax Number: | |
| Mailing Address: | 20333 W 151st St, OLATHE |
| State: | KS |
| Postal Code: | 660615350 |
| Phone Number: | 9137914314 |
| Fax Number: | 9137914204 |
| NPI Enumeration Date: | 12/09/2015 |
| NPI Last Update Date: | 12/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 2079 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| 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 |