Wallace, Davina

Wallace, Davina is an sole proprietor health care provider with primary practice located at 12768 Wood Trail Blvd , Tampa FL 33625-5905. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist, Speech, Language and Hearing Service Providers / Speech-Language Pathologist. Speech, Language and Hearing Service Providers / Speech-Language Pathologist is her primary health care specialty. Wallace, Davina can be contacted via phone (813) 215-6275.

Contact Information

Primary practice address
12768 Wood Trail Blvd Tampa FL 33625-5905
Phone: (813) 215-6275
Fax: (866) 636-0443
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist 222Q00000X
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SA3018 Florida

Profile Details

NPI number 1316282205
LBN Legal business name Wallace, Davina
Credentials M.S.,CCC-SLP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 3rd, 2012
Last updated Dec 15th, 2020 - about 6 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.

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