Individual
CHARLES GLENN DOYLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1230 N DUQUESNE RD, JOPLIN, MO 64801-1509
(417) 782-1443
(417) 782-3240
Mailing address
1230 N DUQUESNE RD, JOPLIN, MO 64801-1509
(417) 782-1443
(417) 782-3240
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2004033755
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
495853517
—
MO
Enumeration date
12/12/2005
Last updated
09/11/2013
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