Provider Demographics
NPI:1346659679
Name:DOYLE, DEBRA (RN, BSN)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:DOYLE
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 HIGHLAND AVE APT D-37
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03076-3461
Mailing Address - Country:US
Mailing Address - Phone:978-935-3135
Mailing Address - Fax:
Practice Address - Street 1:9 HIGHLAND AVE APT D-37
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:NH
Practice Address - Zip Code:03076-3461
Practice Address - Country:US
Practice Address - Phone:978-935-3135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN237721101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor