Provider Demographics
NPI:1083148878
Name:DOYLE, TAMMY (IBCLC)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:DOYLE
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 WAYSIDE LN
Mailing Address - Street 2:
Mailing Address - City:HADDONFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08033-1048
Mailing Address - Country:US
Mailing Address - Phone:215-896-8711
Mailing Address - Fax:
Practice Address - Street 1:840 WAYSIDE LN
Practice Address - Street 2:
Practice Address - City:HADDONFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08033-1048
Practice Address - Country:US
Practice Address - Phone:215-896-8711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-18
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJL-13965405300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes405300000XOther Service ProvidersPrevention Professional