Provider Demographics
NPI:1629391982
Name:BOYLE, KATHLEEN NORA (MSW)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:NORA
Last Name:BOYLE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 SAGINAW ST S
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-4121
Mailing Address - Country:US
Mailing Address - Phone:503-589-4046
Mailing Address - Fax:503-480-0484
Practice Address - Street 1:821 SAGINAW ST S
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-4121
Practice Address - Country:US
Practice Address - Phone:503-589-4046
Practice Address - Fax:503-480-0484
Is Sole Proprietor?:No
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker