Provider Demographics
NPI:1619855988
Name:JAYES, MIA MARGARET
Entity type:Individual
Prefix:
First Name:MIA
Middle Name:MARGARET
Last Name:JAYES
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 1:401 HOLLAND LN APT 609
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-3435
Mailing Address - Country:US
Mailing Address - Phone:847-910-0272
Mailing Address - Fax:
Practice Address - Street 1:6354 WALKER LN STE 250
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-3229
Practice Address - Country:US
Practice Address - Phone:703-971-0602
Practice Address - Fax:949-863-6813
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2204001663235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist