Provider Demographics
NPI:1245493469
Name:CHANDLER REYES, JYLL ANN (MA SLP)
Entity type:Individual
Prefix:
First Name:JYLL
Middle Name:ANN
Last Name:CHANDLER REYES
Suffix:
Gender:F
Credentials:MA SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 N LURING DR STE E
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-6840
Mailing Address - Country:US
Mailing Address - Phone:760-778-6111
Mailing Address - Fax:760-406-4229
Practice Address - Street 1:160 N LURING DR.
Practice Address - Street 2:STE E/H/J
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-9226
Practice Address - Country:US
Practice Address - Phone:760-778-6111
Practice Address - Fax:760-406-4229
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-08
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14146235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist