Provider Demographics
NPI:1285022137
Name:MARY LOUISE DOYLE
Entity Type:Organization
Organization Name:MARY LOUISE DOYLE
Other - Org Name:MARY LOU DOYLE
Other - Org Type:Other Name
Authorized Official - Title/Position:LACTATION CONSULTANT REIKI PRAC.
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY LOUISE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:201-468-2245
Mailing Address - Street 1:11 CLARK CIR
Mailing Address - Street 2:
Mailing Address - City:SOUTH DENNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02660-2508
Mailing Address - Country:US
Mailing Address - Phone:201-468-2245
Mailing Address - Fax:
Practice Address - Street 1:11 CLARK CIR
Practice Address - Street 2:
Practice Address - City:SOUTH DENNIS
Practice Address - State:MA
Practice Address - Zip Code:02660-2508
Practice Address - Country:US
Practice Address - Phone:201-468-2245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-30
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2276431251J00000X, 253Z00000X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care
No282N00000XHospitalsGeneral Acute Care Hospital