Provider Information for 1063189983
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Mrs. KELLY MICHELLE BOYLE MA, LMHC
Sex: Female
NPI: 1063189983
Last Updated: 2021-08-27
Certification Date: 2021-08-27
Certification Date: 2021-08-27
Details
| Name | Value | ||||||||||||
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| NPI | 1063189983 | ||||||||||||
| Enumeration Date | 2021-08-27 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 1111 PIONEER AVE NE OLYMPIA, WA 98506-3300 United States Phone: 360-701-1019 | Fax: | ||||||||||||
| Primary Practice Address | 203 4TH AVE E STE 420 OLYMPIA, WA 98501-1189 United States Phone: 360-701-1019 | Fax: | ||||||||||||
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