Provider Demographics
NPI:1124651369
Name:HAYES, JAMILLA (DPT)
Entity type:Individual
Prefix:
First Name:JAMILLA
Middle Name:
Last Name:HAYES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JAMILLA
Other - Middle Name:
Other - Last Name:DE MAYO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1076 W CHANDLER BLVD STE 103
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-5223
Mailing Address - Country:US
Mailing Address - Phone:480-821-1997
Mailing Address - Fax:480-821-2536
Practice Address - Street 1:10861 E BASELINE RD STE A105
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-7921
Practice Address - Country:US
Practice Address - Phone:480-821-1997
Practice Address - Fax:480-821-2536
Is Sole Proprietor?:No
Enumeration Date:2020-02-17
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-31106225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist