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

Individual provider Speech-Language Pathologist · NPI 1154507820

Mrs. Kathleen Peterson Wallace, MA, CCC-SLP is a Speech-Language Pathologist in Covington, Tennessee. Licensed in Tennessee. Registered with an NPI since 2008.

Licensed in
TN
In the registry since
2008
What do these letters mean?
MA — Master of Arts
A graduate arts 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

425 McLillie Ln
Covington, TN 38019-6413
Phone: (901) 476-7918
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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 SP 0000000512 (TN)

Record details

NPI number1154507820
Entity typeIndividual (Type 1)
GenderFemale
Credentials MA , CCC-SLP
Sole proprietorNo
NPI enumeratedJanuary 12, 2008
Last updated in NPPESJanuary 12, 2008

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