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KAITLYNN WALLACE
NPI 1790249100
Speech-Language Pathologist in Portales, NM

Active since January 30, 2019
1500 S AVE K, STATION 3, SHROC, PORTALES, NM 88130(575) 562-2156 Get Directions Write a Review

NPPES record last updated: July 27, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 27, 2021, Jan 30, 2019 (2 updates tracked since 2019).

About Kaitlynn Wallace NPPES

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

KAITLYNN WALLACE (NPI 1790249100) is an individual speech-language pathologist provider in Portales, New Mexico and active in the NPI registry since January 2019.

NPPES Registry Identity

NPI1790249100
Entity TypeIndividualFemale
Primary Taxonomy235Z00000X
Provider Legal NameKAITLYNN WALLACE
Location Address1500 S AVE K, STATION 3, SHROCPortales, NM 88130
Mailing Address3319 E Forest Lake RdAcampo, CA 95220-9573
Phone(575) 562-2156
Sole ProprietorNo
Enumeration DateJanuary 30, 2019
Last NPPES UpdateJuly 27, 20212 updates tracked since enumeration
NPPES CertifiedJuly 27, 2021
✔ NPI 1790249100 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
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.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1500 S AVE K, Portales, NM 88130
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Other Providers at the Same Location NPPES 20

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

EZEKIEL MAURICIO
Student in an Organized Health Care Education/Training Program
1500 S AVE K, STATION 3, SHROC
PORTALES, NM 88130
Roosevelt County (361) 236-9006
KADIE RAY KIEHNE
Student in an Organized Health Care Education/Training Program
1500 S AVE K
PORTALES, NM 88130
Roosevelt County (800) 367-3668
NICOLE EZCURRA
Student in an Organized Health Care Education/Training Program
1500 S AVE K, STATION 3 SHROC
PORTALES, NM 88130
Roosevelt County (415) 690-0362
MAKENZIE MARIE SMITH
Student in an Organized Health Care Education/Training Program
1500 S AVE K, STATION 3, SHROC
PORTALES, NM 88130
Roosevelt County (575) 562-2127
NORA ANNE MARIE HEILMAN
Student in an Organized Health Care Education/Training Program
1500 S AVE K, STATION 3, SHROC
PORTALES, NM 88130
Roosevelt County (575) 562-2724
AMIRA ASSED
Student in an Organized Health Care Education/Training Program
1500 S AVE K, STATION 3, SHROC
PORTALES, NM 88130
Roosevelt County (575) 540-2180
LAUREN CAGLE
Student in an Organized Health Care Education/Training Program
1500 S AVE K, STATION 3, SHROC
PORTALES, NM 88130
Roosevelt County (916) 216-3159
LAUREN ANNE RODRIQUEZ
Student in an Organized Health Care Education/Training Program
1500 S AVE K, STATION 3, SHROC
PORTALES, NM 88130
Roosevelt County (575) 562-2160

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 Kaitlynn Wallace's NPI number?

The NPI number for Kaitlynn Wallace is 1790249100. It was assigned to this individual provider in the NPPES registry on January 30, 2019.

Where is Kaitlynn Wallace located?

Kaitlynn Wallace practices at 1500 S Ave K Station 3, Shroc, Portales, NM 88130. The listed phone number is (575) 562-2156.

What is Kaitlynn 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 Kaitlynn Wallace was last updated on July 27, 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.