Provider Demographics
NPI:1780170589
Name:DOYLE, ERIN
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:DOYLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8657 LITZSINGER RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63144-2422
Mailing Address - Country:US
Mailing Address - Phone:314-359-3983
Mailing Address - Fax:
Practice Address - Street 1:816 S INTEROCEAN AVE
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:CO
Practice Address - Zip Code:80734-2120
Practice Address - Country:US
Practice Address - Phone:970-854-5180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-03
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017015350225X00000X
TX119306225X00000X
COOT.005091225X00000X
WAOT60877937225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist