Provider Demographics
NPI:1073948147
Name:JAYNES, BEVERLY ANN (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:ANN
Last Name:JAYNES
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 EILEEN DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0424
Mailing Address - Country:US
Mailing Address - Phone:248-334-7807
Mailing Address - Fax:
Practice Address - Street 1:154 EILEEN DR
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0424
Practice Address - Country:US
Practice Address - Phone:248-334-7807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-09
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist