Provider Demographics
NPI:1700153202
Name:DOYLE, NATALIE CHAMPION (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:CHAMPION
Last Name:DOYLE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 CREEK VIEW CT
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-4169
Mailing Address - Country:US
Mailing Address - Phone:828-485-8164
Mailing Address - Fax:
Practice Address - Street 1:302 WESLEY ST
Practice Address - Street 2:SUITE 8
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-1740
Practice Address - Country:US
Practice Address - Phone:423-282-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4350225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist