Provider Demographics
NPI:1417571423
Name:YOKLEY, CHANDLER SUE (MA, CCC-SLP, CBIS)
Entity Type:Individual
Prefix:MRS
First Name:CHANDLER
Middle Name:SUE
Last Name:YOKLEY
Suffix:
Gender:F
Credentials:MA, CCC-SLP, CBIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 SW ANKENY RD
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-5999
Mailing Address - Country:US
Mailing Address - Phone:515-289-9696
Mailing Address - Fax:515-289-9649
Practice Address - Street 1:2854 CORAL CT STE 1
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-2809
Practice Address - Country:US
Practice Address - Phone:319-259-6224
Practice Address - Fax:319-249-6643
Is Sole Proprietor?:No
Enumeration Date:2020-06-04
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA092024235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA42-1308032Medicaid