Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dylan Wake, MSCCC-SLP

Individual provider Speech-Language Pathologist · NPI 1215401963

Dylan Wake, MSCCC-SLP is a Speech-Language Pathologist in Idaho Falls, Idaho. Licensed in Idaho. Registered with an NPI since 2019.

Licensed in
ID
In the registry since
2019
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Practice location Address checks out

3100 Channing Way
Idaho Falls, ID 83404-7533
Phone: (208) 529-7685
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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 SLP-3589 (ID)

Record details

NPI number1215401963
Entity typeIndividual (Type 1)
GenderMale
Credentials MSCCC-SLP
Sole proprietorNo
NPI enumeratedJanuary 16, 2019
Last updated in NPPESJanuary 16, 2019

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