Provider Demographics
NPI:1538390638
Name:DOYLE, GRIFFIN (PHD)
Entity type:Individual
Prefix:
First Name:GRIFFIN
Middle Name:
Last Name:DOYLE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 EAST-WEST HWY
Mailing Address - Street 2:STE. 329
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-2081
Mailing Address - Country:US
Mailing Address - Phone:301-652-8308
Mailing Address - Fax:301-652-8308
Practice Address - Street 1:4400 E WEST HWY
Practice Address - Street 2:STE. 329
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4524
Practice Address - Country:US
Practice Address - Phone:301-652-8308
Practice Address - Fax:301-652-8308
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01794103TC0700X
DCPSY822103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical