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

Individual provider Speech-Language Pathologist · NPI 1699330597

Ellery Caroline Wallace, MS, CCC-SLP is a Speech-Language Pathologist in Bowling Green, Kentucky. Licensed in Kentucky. Registered with an NPI since 2019.

Licensed in
KY
In the registry since
2019
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

2427 Russellville Rd
Bowling Green, KY 42101-3980
Phone: (270) 936-7472
Fax: (317) 520-0820
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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 286690 (KY)

Record details

NPI number1699330597
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS , CCC-SLP
Sole proprietorNo
NPI enumeratedMay 6, 2019
Last updated in NPPESJanuary 26, 2024
Certification dateJuly 25, 2023

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