Provider Demographics
NPI:1821572975
Name:DOYLE, MICHELLE ANN (OTR/L)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ANN
Last Name:DOYLE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 LANE 16 1/2
Mailing Address - Street 2:
Mailing Address - City:WORLAND
Mailing Address - State:WY
Mailing Address - Zip Code:82401-8713
Mailing Address - Country:US
Mailing Address - Phone:307-347-6450
Mailing Address - Fax:
Practice Address - Street 1:502 N ROAD 11
Practice Address - Street 2:
Practice Address - City:WORLAND
Practice Address - State:WY
Practice Address - Zip Code:82401-3141
Practice Address - Country:US
Practice Address - Phone:307-347-8677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYOT-086225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics