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MARY LOUISE WALLACE MA, CCC-SLP
NPI 1114020369
Speech-Language Pathologist in Boulder, CO

Active since September 06, 2006
6672 GUNPARK DR, SUITE 101 C, BOULDER, CO 80301(303) 530-9191 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mary Louise Wallace Ma, Ccc-slp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY LOUISE WALLACE MA, CCC-SLP (NPI 1114020369) is an individual speech-language pathologist provider in Boulder, Colorado, licensed in Colorado (00198044) and active in the NPI registry since September 2006.

NPPES Registry Identity

NPI1114020369
Entity TypeIndividualFemale
Primary Taxonomy235Z00000X
Provider Legal NameMARY LOUISE WALLACECredential: MA, CCC-SLP
Location Address6672 GUNPARK DR, SUITE 101 CBoulder, CO 80301-3387
Mailing Address6672 Gunpark Dr, Suite 101 CBoulder, CO 80301-3387 · (303) 530-9191
Phone(303) 530-9191
Sole ProprietorYes
Enumeration DateSeptember 6, 2006
Last NPPES UpdateJuly 9, 2007
✔ NPI 1114020369 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
License✔ Licensed in CO · 00198044
Definition
The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.
6672 GUNPARK DR, Boulder, CO 80301
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Other Identifiers 1

Medicaid07198047CO

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RIKI FREA M.S., BCBA
Behavior Analyst
6672 GUNPARK DR
BOULDER, CO 80301
Boulder County (303) 530-4972
ASCEND CHILD DEVELOPMENT
Community/Behavioral Health
6672 GUNPARK DR
BOULDER, CO 80301
Boulder County (303) 530-4972
ELIZABETH I. SMITH M.A., CCC-SLP
Speech-Language Pathologist
6672 GUNPARK DR, SUITE 101A
BOULDER, CO 80301
Boulder County (303) 530-9191

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Wallace's NPI number?

The NPI number for Mary Wallace is 1114020369. It was assigned to this individual provider in the NPPES registry on September 6, 2006.

Where is Mary Wallace located?

Mary Wallace practices at 6672 Gunpark Dr Suite 101 C, Boulder, CO 80301. The listed phone number is (303) 530-9191.

What is Mary Wallace's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

When was this NPI record last updated?

The NPPES record for Mary Wallace was last updated on July 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.