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General NPI Number Information
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NPI Number | 1184379885
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Entity Type | Individual
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Provider Name | LILY ELIZABETH WALLJASPER MA, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 02/21/2022
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 1215 21ST AVE S
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City | NASHVILLE
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State | TN
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Zip | 37232-0014
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Country | US
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Telephone | 615-936-3963
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Fax |
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Provider Business Mailing Address
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Address Line | 1715 COCKRILL ST
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City | NASHVILLE
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State | TN
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Zip | 37208-2012
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Country | US
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Telephone | 608-354-4192
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 7354
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License Number State | TN
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