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

Shannon Waller

Individual provider Speech-Language Pathologist · NPI 1053044537

Shannon Waller is a Speech-Language Pathologist in Grand Rapids, Michigan. Licensed in Michigan. Registered with an NPI since 2022.

Licensed in
MI
In the registry since
2022
Specialties on file
2

Practice location Address checks out

235 Wealthy St SE
Grand Rapids, MI 49503-5247
Phone: (800) 528-8989
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X (MI)
Speech-Language Pathologist Taxonomy 235Z00000X · Licence 7101001306 (MI)

Record details

NPI number1053044537
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 2, 2022
Last updated in NPPESJuly 2, 2022
Certification dateJuly 1, 2022
Mailing address235 Wealthy St Se, Grand Rapids, MI 49503-5247

Other providers in Grand Rapids