Individual
IVY ANNA GILES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
16500 VENTURA BLVD STE 414, ENCINO, CA 91436-5050
(818) 788-1003
(818) 788-1135
Mailing address
4420 CARPENTER AVE, STUDIO CITY, CA 91607-4111
(818) 788-1002
(818) 788-1135
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP8625
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SP8625
SPEECH LANGUAGE PATHOLOGY BOARD
CA
Enumeration date
10/25/2012
Last updated
10/25/2012
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