Provider Demographics
NPI:1932536448
Name:DOYLE, DOROTHY BENNETT
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:BENNETT
Last Name:DOYLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DOROTHY
Other - Middle Name:BENNETT
Other - Last Name:HAUBNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:34 WINNEBAGO CIR
Mailing Address - Street 2:
Mailing Address - City:CHEROKEE VILLAGE
Mailing Address - State:AR
Mailing Address - Zip Code:72529-4103
Mailing Address - Country:US
Mailing Address - Phone:870-257-3100
Mailing Address - Fax:870-257-3100
Practice Address - Street 1:34 WINNEBAGO CIR
Practice Address - Street 2:
Practice Address - City:CHEROKEE VILLAGE
Practice Address - State:AR
Practice Address - Zip Code:72529-4103
Practice Address - Country:US
Practice Address - Phone:870-257-3100
Practice Address - Fax:870-257-3100
Is Sole Proprietor?:No
Enumeration Date:2013-09-28
Last Update Date:2013-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP3392235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist