Provider Demographics
NPI:1063998755
Name:SCHLEY, GABRIELLE ALLISON
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:ALLISON
Last Name:SCHLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33699 N WASH VIEW RD
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-3020
Mailing Address - Country:US
Mailing Address - Phone:808-838-9961
Mailing Address - Fax:
Practice Address - Street 1:33622 N MOUNTAIN VISTA BLVD
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85142-3162
Practice Address - Country:US
Practice Address - Phone:480-987-5380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-16
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTSLP11274235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist