Skye Wallace, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA18149 Issued in FL

Practice address

1514 E Chelsea St
Tampa, FL 33610-6114

Phone

(813) 238-8232

NPI assigned

Aug 22, 2020

Last updated

Aug 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1598054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598054400000",
    "number": "1598377327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 N 12TH ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336023764",
            "telephone_number": "561-859-9792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 E CHELSEA ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336106114",
            "telephone_number": "813-238-8232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "SKYE",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-22",
        "last_updated": "2020-08-22",
        "certification_date": "2020-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA18149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Wallace
• Davina Wallace, M.S.,CCC-SLP
• Debra Ann Wallace
• Peggy Lynn Wallace, ARNP
• Sergio Wallace
• Tiaja Wallace
• Yelda N Wallace
• Zandra Wynette Wallace
• Maria Wallen
• Marva Ann Marie Wallen, RN

• Speech-Language Pathologist in Tampa, FL
• Providers in Tampa, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.