Jemma Holley Imwalle, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Wallace, NC
NPI 1073576260 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1073576260
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 2899 (NC)
- Practice address
- 514 E Murphy St
Wallace, NC 28466-1931 - Phone
- (910) 285-2255
- Fax
- (877) 777-1038
- NPI assigned
- Apr 10, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2899 | NC | MD | Chiropractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2899 | NC | Yes |
Addresses
Primary practice location
514 E Murphy St
Wallace, NC 28466-1931
Mailing address
514 E Murphy St
Wallace, NC 28466-1931
Phone (910) 285-2255
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7411091 | Medicaid | NC |
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- Interim Healthcare of the Eastern Carolinas, Inc
- Michael James
- Jeffrey B Pupp
- Johnson Blackburn
All providers in Wallace, NC · Speech-Language Pathologist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.