Mary Wallace, MA, CCC-SLP

NPI: 1114020369

Mary Wallace, MA, CCC-SLP

Q: What is Mary Wallace's NPI number?

Mary Wallace's NPI number is 1114020369, a unique 10-digit identifier issued by CMS.

Q: What does Mary Wallace specialize in?

Mary Wallace specializes in Speech-Language Pathologist, taxonomy code 235Z00000X.

Q: Where does Mary Wallace practice?

Mary Wallace practices in Boulder, CO 80301-3387.

Q: When was Mary Wallace's NPI issued?

Mary Wallace's NPI was issued on September 6, 2006.

Q: What is Mary Wallace's provider type?

Mary Wallace is an Individual Provider under CMS NPI Type 1.

ActiveIndividual ProviderSpeech-Language Pathologist

NPI issued: September 6, 2006

Quick Facts

NPI Number

1114020369

TypeIndividual

StatusActive

SpecialtySpeech-Language Pathologist

Taxonomy235Z00000X — Speech-Language Pathologist

Phone

(303) 530-9191

StateCO

NPI Validation Status: Verified

✅Valid 10-digit NPI number (1114020369)

✅Active status confirmed

✅Verified by CMS NPPES Registry

✅HIPAA compliant identifier

✅Enumeration date on file (September 6, 2006)

Data source: CMS NPPES

Provider Overview

MARY WALLACE, MA, CCC-SLP is a Speech-Language Pathologist provider based in Boulder, CO who has been registered with CMS since 2006. This NPI is currently Active under CMS NPPES registry.

Provider Details

NPI Number1114020369

Provider TypeIndividual Provider

GenderFemale

CredentialMA, CCC-SLP

StatusActive

Enumeration DateSeptember 6, 2006

Practice Location

CityBoulder

StateCO

ZIP Code80301-3387

Phone(303) 530-9191

Specialties & Licenses

★ Primary

SpecialtySpeech-Language Pathologist

Taxonomy Code235Z00000X

License StateCO

Mailing Address

CityBoulder

StateCO

ZIP Code80301-3387

Phone(303) 530-9191

Same as practice location

How to Use This NPI

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For Insurance Billing

Use NPI 1114020369 in Box 33 of the CMS-1500 claim form. This number is required by all major insurance carriers to identify the billing provider and process electronic medical claims.

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For Credentialing

Reference NPI 1114020369for provider credential verification. Hospital systems, state licensing boards, and CAQH directories query this number to verify the provider's active clinical status.

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For Patients

Share NPI 1114020369 with your insurance company. If you need to verify out-of-network benefits or file a reimbursement claim, your insurance provider will require this number to process it.

About Speech-Language Pathologist

Speech-Language Pathologists assess, diagnose, treat, and help prevent communication and swallowing disorders in children and adults, assisting with speech, language, voice, and fluency.

Browse all Speech-Language Pathologistproviders →

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Speech-Language Pathologist Providers in the US