Wallace, Kaitlynn

Wallace, Kaitlynn is an individual health care provider with primary practice located at 1500 S Ave K Station 3, Shroc, Portales NM 88130. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, 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, Kaitlynn can be contacted via phone (575) 562-2156.

Contact Information

Primary practice address
1500 S Ave K Station 3, Shroc Portales NM 88130
Phone: (575) 562-2156
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X California
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X

Profile Details

NPI number 1790249100
LBN Legal business name Wallace, Kaitlynn
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2019
Last updated Jul 27th, 2021 - about 5 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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