Provider Demographics
NPI:1841794484
Name:CHAMBLN, JENAY MONIQUE (SLPA)
Entity Type:Individual
Prefix:
First Name:JENAY
Middle Name:MONIQUE
Last Name:CHAMBLN
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1113 E SHEFFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-8607
Mailing Address - Country:US
Mailing Address - Phone:602-715-6026
Mailing Address - Fax:
Practice Address - Street 1:5314 N 7TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-2805
Practice Address - Country:US
Practice Address - Phone:602-277-5006
Practice Address - Fax:602-277-5042
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-20
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty