Jessica Wallace

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP.12089 Issued in OH

Practice address

2900 Knox School Rd
Alliance, OH 44601-9021

Phone

(330) 938-1122

NPI assigned

Dec 1, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1417392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1285031682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14277 S MAIN ST",
            "city": "BELOIT",
            "state": "OH",
            "postal_code": "446099504",
            "telephone_number": "330-938-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 KNOX SCHOOL RD",
            "city": "ALLIANCE",
            "state": "OH",
            "postal_code": "446019021",
            "telephone_number": "330-938-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "JESSICA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-01",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "2015123",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.12089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores East, LP
• James Joseph Waldron, PHARMD
• Walgreen Co
• Jacqueline Walker
• Debra J Wallace, PCC-S, LICDC
• Lisa Ann Walters, L.M.T.
• Sherri Ann Ward, STNA
• Dirk Jason Warner, OD
• Jennifier Le Wassem, LPN
• Shelley M Weatherspoon, LISW, LICDC

• Speech-Language Pathologist in Alliance, OH
• Providers in Alliance, OH by specialty
• Speech-Language Pathologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.