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1942406723
JOHANNA WALLACE
CYPRESS, TX
NPI
1942406723
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: FL SA8966)
Enumeration Date
2007-06-26
Last Update Date
2024-08-18
Business Address
JOHANNA WALLACE MS CCC-SLP
11440 MATZKE RD
CYPRESS, TX 77429-5015
Phone number: 850-512-0156
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Mailing Address
JOHANNA WALLACE MS CCC-SLP
13727 WAVERLY CREST CT STE 200
CYPRESS, TX 77429-6831
Phone number: 850-512-0156
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