Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | ||
N | 225XP0200X | Occupational Therapist - Pediatrics | 056.008244 | IL |
NPI | 1477731289 |
---|---|
Provider Name | Courtney Erin Doyle |
First Address | Mokena, IL 60448-7501 |
Second Address | Mokena, IL 60448 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2008 |
Last Update Date | 04/06/2018 |