Provider Demographics
NPI:1861515900
Name:DOYLE, IRENE (MED, LADC, ICADC)
Entity type:Individual
Prefix:MS
First Name:IRENE
Middle Name:
Last Name:DOYLE
Suffix:
Gender:F
Credentials:MED, LADC, ICADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61A MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:GREENLAND
Mailing Address - State:NH
Mailing Address - Zip Code:03840-6201
Mailing Address - Country:US
Mailing Address - Phone:603-516-8197
Mailing Address - Fax:
Practice Address - Street 1:272 COUNTY FARM RD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-6003
Practice Address - Country:US
Practice Address - Phone:603-516-8197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH533101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH533OtherLICENSE ALCOHOL & DRUG CO