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General NPI Number Information
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NPI Number | 1174292585
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Entity Type | Individual
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Provider Name | SHANNON DOYLE LCSW-C
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Gender | Female
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Dates
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Enumeration Date | 09/09/2021
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Last Update Date | 09/09/2021
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Provider Practice Location Address
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Address Line | 8840 STANFORD BLVD STE 1600
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City | COLUMBIA
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State | MD
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Zip | 21045-5909
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Country | US
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Telephone | 240-512-0141
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Fax | 240-512-0151
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Provider Business Mailing Address
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Address Line | 12 DRAWBRIDGE CT
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City | CATONSVILLE
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State | MD
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Zip | 21228-2401
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Country | US
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Telephone | 443-204-3888
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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