| Doctor Name: | MS. JENNIFER GAIL WILEY |
| NPI Number: | 1417251240 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS |
| License Number: | SLPL5171 |
| Business Practice Address: | 17100 E Shea Blvd Suite #225 Fountain Hills, AZ - 852686625 |
| Business Phone Number: | 4808374565 |
| Business Fax Number: | 8889578277 |
| Mailing Address: | 17100 E Shea Blvd, Suite #225 FOUNTAIN HILLS |
| State: | AZ |
| Postal Code: | 852686625 |
| Phone Number: | 4808374565 |
| Fax Number: | 8889578277 |
| NPI Enumeration Date: | 01/09/2011 |
| NPI Last Update Date: | 01/09/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SLPL5171 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |