1821269192 NPI number — MRS. VALERIE K. DOYLE P.T.

Table of content: CAROL DANTER LCSW (NPI 1841312048)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821269192 NPI number — MRS. VALERIE K. DOYLE P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DOYLE
Provider First Name:
VALERIE
Provider Middle Name:
K.
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
P.T.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821269192
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/24/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
690 N COFCO CENTER CT
Provider Second Line Business Mailing Address:
SUITE 260
Provider Business Mailing Address City Name:
PHOENIX
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85008-6462
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
602-279-6905
Provider Business Mailing Address Fax Number:
602-279-6934

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1231 WILLOW CREEK RD
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
PRESCOTT
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
86301-1404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
928-443-1120
Provider Business Practice Location Address Fax Number:
928-443-1123
Provider Enumeration Date:
03/14/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2251H1200X , with the licence number:  3801 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 321743 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".




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