MS. GWENDOLYN DEANE WALLACE MS-CF,SLP
NPI 1730770207
Speech-Language Pathologist in Hattiesburg, MS

Q: What is Gwendolyn Wallace's NPI number?

The NPI number for Gwendolyn Wallace is 1730770207. It was assigned to this individual provider in the NPPES registry on January 28, 2021.

Q: What is Gwendolyn Wallace's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Gwendolyn Wallace was last updated on January 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since January 28, 2021

4805 W 4TH ST, HATTIESBURG, MS 39402(601) 270-6968(601) 758-0982 Get Directions Write a Review

NPPES record last updated: January 28, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Ms. Gwendolyn Deane Wallace Ms-cf,slp NPPES

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

MS. GWENDOLYN DEANE WALLACE MS-CF,SLP (NPI 1730770207) is an individual speech-language pathologist provider in Hattiesburg, Mississippi, licensed in Mississippi (S-4735) and active in the NPI registry since January 2021.

NPPES Registry Identity

NPI1730770207

Entity TypeIndividualFemale

Primary Taxonomy235Z00000X

Provider Legal NameMS. GWENDOLYN DEANE WALLACECredential: MS-CF,SLP

Location Address4805 W 4TH STHattiesburg, MS 39402-1019

Mailing Address4805 W 4th StHattiesburg, MS 39402-1019 · (607) 270-6968 · Fax (601) 758-0982

Phone(601) 270-6968

Fax(601) 758-0982

Sole ProprietorYes

Enumeration DateJanuary 28, 2021

NPPES CertifiedJanuary 28, 2021

✔ NPI 1730770207 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 MS · S-4735

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.

4805 W 4TH ST, Hattiesburg, MS 39402

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 9

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

KELLI BANTA

Speech-Language Pathologist