Provider Demographics
NPI:1679855951
Name:DOYLE, STEPHANIE (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:DOYLE
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10435 DOWNSVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-1732
Mailing Address - Country:US
Mailing Address - Phone:301-766-8222
Mailing Address - Fax:
Practice Address - Street 1:2058 POMONA WAY
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-1255
Practice Address - Country:US
Practice Address - Phone:908-675-0780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119005326225X00000X
MD09762225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1679855951OtherOCCUPATIONAL THERAPIST
MD1679855951OtherOCCUPATIONAL THERAPIST
VA1679855951OtherOCCUPATIONAL THERAPIST