Provider Demographics
NPI:1477577146
Name:BOYLE, TINA ESTERLE (MS, CCC-A)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:ESTERLE
Last Name:BOYLE
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7600 W HIGHWAY 146
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PEWEE VALLEY
Mailing Address - State:KY
Mailing Address - Zip Code:40056-8109
Mailing Address - Country:US
Mailing Address - Phone:502-241-6519
Mailing Address - Fax:502-241-6589
Practice Address - Street 1:7600 W HIGHWAY 146
Practice Address - Street 2:SUITE 300
Practice Address - City:PEWEE VALLEY
Practice Address - State:KY
Practice Address - Zip Code:40056-8109
Practice Address - Country:US
Practice Address - Phone:502-241-6519
Practice Address - Fax:502-241-6589
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0308231H00000X
KY0720237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter