Provider Demographics
NPI:1356046239
Name:DOYLE, JALYN ROSE (SLP)
Entity type:Individual
Prefix:
First Name:JALYN
Middle Name:ROSE
Last Name:DOYLE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11411 ALBANY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA
Mailing Address - State:IN
Mailing Address - Zip Code:46561-1305
Mailing Address - Country:US
Mailing Address - Phone:574-217-3918
Mailing Address - Fax:
Practice Address - Street 1:11411 ALBANY RIDGE DR
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:IN
Practice Address - Zip Code:46561-1305
Practice Address - Country:US
Practice Address - Phone:574-217-3918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-31
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN46004205A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist