Wallace, Diane
Wallace, Diane is an sole proprietor health care provider with primary practice located at 11150 Montwood Drive Bldg A., El Paso TX 79936. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Wallace, Diane can be contacted via phone (915) 594-0202.Contact Information
Primary practice address
11150 Montwood Drive Bldg A.
El Paso TX 79936
Phone: (915) 594-0202
Fax: (915) 591-2116
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 14445 | Texas |
Profile Details
| NPI number | 1659400471 |
|---|---|
| LBN Legal business name | Wallace, Diane |
| Credentials | SLP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 5th, 2007 |
| Last updated | Nov 2nd, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659400471 | NPPES |
| Texas | MEDICAID | 004638502 |
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