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1114020369
MARY LOUISE WALLACE
BOULDER, CO
NPI
1114020369
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: CO 00198044)
Enumeration Date
2006-09-06
Last Update Date
2007-07-09
Business Address
-- MARY LOUISE WALLACE MA, CCC-SLP
6672 GUNPARK DR SUITE 101 C
BOULDER, CO 80301-3387
Phone number: 303-530-9191
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Mailing Address
-- MARY LOUISE WALLACE MA, CCC-SLP
6672 GUNPARK DR SUITE 101 C
BOULDER, CO 80301-3387
Phone number: 303-530-9191
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