Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Davina Wallace, MS, CCC-SLP

Individual provider Developmental Therapist · NPI 1316282205

Davina Wallace, MS, CCC-SLP is a Developmental Therapist in Tampa, Florida. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2012
Specialties on file
2
What do these letters mean?
MS — Master of Science
A graduate science degree.
CCC-SLP — Certificate of Clinical Competence in Speech-Language Pathology
A speech-language pathologist certified by ASHA.

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Practice location Address checks out

12768 Wood Trail Blvd
Tampa, FL 33625-5905
Phone: (813) 215-6275
Fax: (866) 636-0443
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence SA3018 (FL)
Developmental Therapist Taxonomy 222Q00000X

Record details

NPI number1316282205
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS , CCC-SLP
Sole proprietorYes
NPI enumeratedDecember 3, 2012
Last updated in NPPESDecember 15, 2020
Certification dateDecember 15, 2020

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