Provider Demographics
NPI:1215609839
Name:DOYLE, DEANNA LEE (LMT)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:LEE
Last Name:DOYLE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 WILLOW DELL DR
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:KY
Mailing Address - Zip Code:41039-8494
Mailing Address - Country:US
Mailing Address - Phone:606-748-0579
Mailing Address - Fax:
Practice Address - Street 1:107 BRANDON WAY
Practice Address - Street 2:
Practice Address - City:MT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-8500
Practice Address - Country:US
Practice Address - Phone:859-499-1009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-01
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY267715225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist