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

Individual provider Speech-Language Pathologist · NPI 1114402575

Mallory Jean Waisanen, CCC-SLP is a Speech-Language Pathologist in Flint, Michigan. Works from 2 locations. Licensed in Michigan.

Licensed in
MI
In the registry since
2018
What do these letters mean?
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

1 Hurley Plz
Flint, MI 48503-5902
Phone: (810) 429-8923
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2919 Wilder Rd, Bay City, MI 48706-9299 — (989) 671-5738

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 7101005773 (MI)

Record details

NPI number1114402575
Entity typeIndividual (Type 1)
GenderFemale
Credentials CCC-SLP
Sole proprietorNo
NPI enumeratedOctober 1, 2018
Last updated in NPPESDecember 8, 2022
Certification dateDecember 8, 2022

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