Provider Demographics
NPI:1013748078
Name:GILES-EWELL, JAYLN AVERY (LAAT, ATR-P)
Entity type:Individual
Prefix:
First Name:JAYLN
Middle Name:AVERY
Last Name:GILES-EWELL
Suffix:
Gender:F
Credentials:LAAT, ATR-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840
Mailing Address - Country:US
Mailing Address - Phone:201-273-8098
Mailing Address - Fax:
Practice Address - Street 1:339 MAIN ST.
Practice Address - Street 2:SUITE A
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840
Practice Address - Country:US
Practice Address - Phone:201-273-8098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ16LA00004300221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist