Provider Demographics
NPI:1154812121
Name:DOYLE, COLLEEN (MSW)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:DOYLE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22995 MINERVA DR
Mailing Address - Street 2:
Mailing Address - City:BRAMBLETON
Mailing Address - State:VA
Mailing Address - Zip Code:20148-7007
Mailing Address - Country:US
Mailing Address - Phone:703-957-4425
Mailing Address - Fax:571-252-1245
Practice Address - Street 1:22995 MINERVA DR
Practice Address - Street 2:
Practice Address - City:BRAMBLETON
Practice Address - State:VA
Practice Address - Zip Code:20148-7007
Practice Address - Country:US
Practice Address - Phone:703-957-4425
Practice Address - Fax:571-252-1245
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-24
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool