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

Individual provider Speech-Language Pathologist · NPI 1730770207

MS. Gwendolyn Deane Wallace, MS-CF, SLP is a Speech-Language Pathologist in Hattiesburg, Mississippi. Practices as a sole proprietor. Licensed in Mississippi.

Licensed in
MS
In the registry since
2021
What do these letters mean?
SLP — Speech-Language Pathologist
Treats speech, language and swallowing disorders.

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Practice location Address checks out

4805 W 4th St
Hattiesburg, MS 39402-1019
Phone: (601) 270-6968
Fax: (601) 758-0982
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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 S-4735 (MS)

Record details

NPI number1730770207
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS-CF , SLP
Sole proprietorYes
NPI enumeratedJanuary 28, 2021
Last updated in NPPESJanuary 28, 2021
Certification dateJanuary 28, 2021

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