Provider Demographics
NPI:1477264505
Name:DOYLE, ASHLEY L
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:L
Last Name:DOYLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:WILLIAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1480 COLORADO GULCH DR
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-9643
Mailing Address - Country:US
Mailing Address - Phone:469-352-1212
Mailing Address - Fax:
Practice Address - Street 1:3691 E 20TH N
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83401-1813
Practice Address - Country:US
Practice Address - Phone:469-352-1212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-09
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
MTRBT-22-245854106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTRBT-22-245854OtherBACB