Provider Demographics
NPI:1568568673
Name:DOYLE, ANDRIA LEIGH (PHD)
Entity Type:Individual
Prefix:
First Name:ANDRIA
Middle Name:LEIGH
Last Name:DOYLE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ANDRIA
Other - Middle Name:LEIGH
Other - Last Name:BLACK
Other - Suffix:II
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:210 E MILLTOWN RD B
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-1246
Mailing Address - Country:US
Mailing Address - Phone:330-345-0955
Mailing Address - Fax:330-345-3420
Practice Address - Street 1:210 E MILLTOWN RD # B
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-1246
Practice Address - Country:US
Practice Address - Phone:330-345-0955
Practice Address - Fax:330-345-3420
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6078103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical