MARRI WALLACE (NPI# 1871989756) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871989756 |
| Entity Type | Individual |
| Full Name | MARRI WALLACE |
| Other Name | MARRI BANKS |
| Credential | MS, CCC-SLP |
| Practice Address |
410 New Bridge St Suite 10-a Jacksonville NC 28540-4739 |
| Practice Telephone | 9103472212 |
| Practice Fax Number | 9103781747 |
| Mailing Telephone | 9103472212 |
| Mailing Fax Number | 9103781747 |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2015-04-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | 8552 | NC | Speech, Language and Hearing Service Providers |
| Street Address |
410 NEW BRIDGE ST SUITE 10-A |
| City | JACKSONVILLE |
| State | NC |
| Zip Code | 28540-4739 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710930631 | Kamal G Abulsaad | Psychologist | 410 New Bridge St, Sute 9-b, Jacksonville, NC 28540-4739 | 2006-05-19 |
| 1386175586 | Kimberly Blair Lark | Occupational Therapist | 410 New Bridge St, Suite 10-a, Jacksonville, NC 28540-4739 | 2017-03-21 |
| 1932550712 | Kayla Ann Sampson | Speech-Language Pathologist | 410 New Bridge St, Jacksonville, NC 28540-4739 | 2016-06-23 |
| 1417355249 | Mary Kathleen Galbraith | Speech-Language Pathologist | 410 New Bridge St, Suite 10-a, Jacksonville, NC 28540-4739 | 2014-12-10 |
| 1700212727 | Kristen Marie Bartold | Physical Therapist | 410 New Bridge St, Suite 10-a, Jacksonville, NC 28540-4739 | 2013-09-23 |
| 1295177509 | Alicia Lynn Nance | Occupational Therapist | 410 New Bridge St, Suite 10-a, Jacksonville, NC 28540-4739 | 2013-07-28 |
| 1245583046 | Danielle Boyer Carson | Occupational Therapist | 410 New Bridge St, Suite 10-a, Jacksonville, NC 28540-4739 | 2012-10-18 |
| 1952663239 | Holly Hoskinson | Speech-Language Pathologist | 410 New Bridge St, Suite 10-a, Jacksonville, NC 28540-4739 | 2012-06-12 |
| 1922368554 | Rebecca Tilson Epperson | Physical Therapist | 410 New Bridge St, Suite 10a, Jacksonville, NC 28540-4739 | 2012-05-16 |
| 1487983870 | Celeste Day | Speech-Language Pathologist | 410 New Bridge St, Suite 10-a, Jacksonville, NC 28540-4739 | 2009-12-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467067785 | Knox Counseling and Consulting, PC | Case Management | 513 New Bridge St-suite 500, Jacksonville, NC 28540 | 2020-09-14 |
| 1629696646 | Mary Ann Caldwell | Counselor | 2496 Northwoods Dr., Jacksonville, NC 28540 | 2020-07-07 |
| 1639793748 | Johnathon T Brewer | Military Health Care Provider | 100 White St, Jacksonville, NC 28540 | 2020-06-04 |
| 1043782899 | Brice Rivra | Military Health Care Provider | Rr 612 Loop Road, Jacsksonvile, NC 28540 | 2018-12-18 |
| 1649768599 | Alexander John Pybus | Student in an Organized Health Care Education/Training Program | White St Bldg As-100, Jacksonville, NC 28540 | 2018-04-26 |
| 1881198182 | Orleiquis Guerra | Military Health Care Provider | Marine Corps Air Station New River Bldg As-100, Jacksonville, NC 28540 | 2018-03-21 |
| 1558864736 | Andrew Louis Monroe | General Practice | As-100 White Street, Jacksonville, NC 28540 | 2018-03-14 |
| 1588183198 | Citizen Community Transport, LLC | Private Vehicle | 220 Foxwood Ct., Jacksonville, NC 28540 | 2017-09-14 |
| 1558886242 | Brandon Jay Smith | Military Health Care Provider | E Street Bldg G770, Camp Lejeune, NC 28540 | 2017-08-03 |
| 1174043244 | Jason Waters | Military Health Care Provider | White St, Bldg As-100, Jacksonville, NC 28540 | 2017-06-21 |
| Find all providers in zip 28540 | ||||
| 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 |
|---|---|---|---|---|
| 1245848514 | Danielle Huckaba | Speech-Language Pathologist | 12023 Wren Hollow Ct, Jacksonville, FL 32246-7787 | 2020-07-22 |
| 1699392209 | Paige E Searcy | Speech-Language Pathologist | 907 Greenridge Rd, Jacksonville, FL 32207-5251 | 2020-06-30 |
| 1568086619 | Carmen Schneider | Speech-Language Pathologist | 7701 Timberlin Park Blvd Apt 831, Jacksonville, FL 32256-5447 | 2020-06-04 |
| 1730702713 | Jennifer Horn Debardeleben | Speech-Language Pathologist | 2101 W Palm Ave, Jacksonville, FL 32254-1734 | 2020-05-25 |
| 1508485509 | Growing Voices Therapies, LLC | Speech-Language Pathologist | 12964 Julington Ridge Dr E, Jacksonville, FL 32258-3412 | 2020-04-10 |
| 1215561352 | Lori Connon | Speech-Language Pathologist | 2334 Covington Creek Cir W, Jacksonville, FL 32224-1177 | 2020-02-27 |
| 1922631779 | Homegrown Communication-slp, LLC | Speech-Language Pathologist | 5163 Shirley Ave, Jacksonville, FL 32210-3145 | 2020-02-20 |
| 1194357517 | Lauren Lynne Blunk | Speech-Language Pathologist | 1010 N Davis St, Jacksonville, FL 32209-6824 | 2020-02-05 |
| 1669018255 | Ying Dong | Speech-Language Pathologist | 7262 Deerfoot Point Cir Unit 3, Jacksonville, FL 32256-8623 | 2019-11-19 |
| 1710543764 | Lesley Nicole Summers | Speech-Language Pathologist | 6817 Southpoint Pkwy Ste 1701, Jacksonville, FL 32216-6298 | 2019-05-15 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 28540 |
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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.