MRS. KELLY FUTCH WALL (NPI# 1851811988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851811988 |
| Entity Type | Individual |
| Full Name | MRS. KELLY FUTCH WALL |
| Credential | MA, CF-SLP |
| Practice Address |
1460 Pocotaligo Rd Fairfax SC 29827-6826 |
| Practice Telephone | (803) 943-6401 |
| Mailing Telephone | 8039436401 |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2017-06-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | 6017 | SC | Speech, Language and Hearing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194290338 | Kelly White Wall | Nurse Practitioner | 414 Lugenia Dr, Vidalia, GA 30474-7210 | 2018-10-03 |
| 1225463060 | Kelly E. Wall | Nurse Practitioner | 1199 Prince Ave, #7, Athens, GA 30606-2797 | 2013-09-12 |
| Street Address |
1460 POCOTALIGO RD |
| City | FAIRFAX |
| State | SC |
| Zip Code | 29827-6826 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710588942 | Southern Oaks Therapy Services LLC | Speech-Language Pathologist | 1460 Pocotaligo Rd, Fairfax, SC 29827-6826 | 2020-11-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467843078 | We Care Family Resource LLC | Point of Service | 513 Bayshore Dr., Fairfax, SC 29827 | 2015-02-18 |
| 1154606440 | Robert M. Haberkorn Dds | Clinic/Center | 1987 Allendale Fairfax Hwy., Fairfax, SC 29827 | 2011-10-18 |
| 1144370503 | Allendale County Hospital Board | Clinic/Center | 1787 Allendale Fairfax Highway, Fairfax, SC 29827 | 2007-01-10 |
| 1336246677 | Allendale County Hospital Board | Skilled Nursing Facility | 185 Revolutionary Trail, Fairfax, SC 29827 | 2006-09-20 |
| 1881646669 | Shenika L. Marshall-hill | Counselor | 1594 Beaufort Ave. S., Fairfax, SC 29827 | 2006-05-17 |
| 1588623540 | Rebecca Lynn Wilkes | Nurse Practitioner | 333 Revolutionary Trail, Fairfax, SC 29827 | 2006-03-20 |
| 1497745012 | Robert M Haberkorn | Dentist | 1987 Allendale-fairfax Hwy, Fairfax, SC 29827 | 2005-10-25 |
| 1588815021 | James Robert Mynatt | Nurse Practitioner | 333 Revolutionary Trail, Fairfax, SC 29827 | 2008-10-02 |
| 1063607646 | Mol Ky | General Practice | 333 Revolutionary Trail, Fairfax, SC 29827 | 2007-09-07 |
| 1053475566 | Low Country Health Care System, Inc | Pharmacy | 333 Revolutionary Trail, Farifax, SC 29827 | 2006-12-20 |
| Find all providers in zip 29827 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| 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. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780282152 | Rachel Tsipora Chalom | Speech-Language Pathologist | 10565 Fairfax Blvd Ste 200, Fairfax, VA 22030-3104 | 2020-10-16 |
| 1629681861 | Magnolia Educational Services | Speech-Language Pathologist | 4403 Dixie Hill Rd Apt 205, Fairfax, VA 22030-9061 | 2020-08-27 |
| 1336635713 | Mary Pat Mcguire Peri | Speech-Language Pathologist | 9909 Laurel St, Fairfax, VA 22032-1013 | 2018-07-09 |
| 1538665740 | Amie Lynn Russian | Speech-Language Pathologist | 8270 Willow Oaks Corporate Dr Ofc, Fairfax, VA 22031-4511 | 2018-04-05 |
| 1679078794 | Katherine Willcox-bein | Speech-Language Pathologist | 8270 Willow Oaks Corporate Dr # 2128, Fairfax, VA 22031-4511 | 2018-03-29 |
| 1720580475 | Brandhorst Speech Therapy | Speech-Language Pathologist | 562 Meadow Oak Cir, Fairfax, IA 52228-4709 | 2018-03-07 |
| 1427559533 | Stacey Allman | Speech-Language Pathologist | 8270 Willow Oaks Co Dr Ste 2131, Fairfax, VA 22031-4511 | 2018-02-23 |
| 1801397294 | Jonelle Craig Shipley | Speech-Language Pathologist | 8270 Willow Oaks Corporate Dr Ste 2129, Fairfax, VA 22031-4511 | 2018-02-22 |
| 1154822682 | Kristy Cannon | Speech-Language Pathologist | 8270 Willow Oaks Co Dr Ste 2129, Fairfax, VA 22031-4511 | 2018-02-21 |
| 1710487343 | Nicole Mariah Dobson | Speech-Language Pathologist | 9524 Old Creek Dr, Fairfax, VA 22032-1238 | 2018-02-20 |
| Find all providers in FAIRFAX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.