Provider Demographics
NPI:1578649349
Name:DOYLE, SUSAN E (MSW)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:E
Last Name:DOYLE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 E 23RD ST
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-4814
Mailing Address - Country:US
Mailing Address - Phone:269-832-0172
Mailing Address - Fax:
Practice Address - Street 1:231 TROWBRIDGE ST
Practice Address - Street 2:SUITE 12
Practice Address - City:ALLEGAN
Practice Address - State:MI
Practice Address - Zip Code:49010-1359
Practice Address - Country:US
Practice Address - Phone:269-832-0172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010887901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical