Provider Demographics
NPI:1124231311
Name:DOYLE, STEFANI L (SLP, AVT)
Entity Type:Individual
Prefix:MRS
First Name:STEFANI
Middle Name:L
Last Name:DOYLE
Suffix:
Gender:F
Credentials:SLP, AVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1541 PENNSBURY DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-7768
Mailing Address - Country:US
Mailing Address - Phone:610-918-1556
Mailing Address - Fax:610-938-9886
Practice Address - Street 1:200 YALE AVE
Practice Address - Street 2:
Practice Address - City:MORTON
Practice Address - State:PA
Practice Address - Zip Code:19070-1918
Practice Address - Country:US
Practice Address - Phone:610-938-9000
Practice Address - Fax:610-938-9886
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL005871L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019340490002Medicaid