Doctor Name: | BRENDA DOYLE |
NPI Number: | 1295129534 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PC |
License Number: | AC0811 |
Business Practice Address: | 40 S Dundalk Ave Dundalk, MD - 212224267 |
Business Phone Number: | 4102858157 |
Business Fax Number: | 4102858298 |
Mailing Address: | 1925 Greenspring Dr, TIMONIUM |
State: | MD |
Postal Code: | 210934128 |
Phone Number: | 4104539553 |
Fax Number: | 4436121488 |
NPI Enumeration Date: | 03/25/2015 |
NPI Last Update Date: | 03/25/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | AC0811 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |