Provider Demographics
NPI:1629404439
Name:BOELE, MAIJU KAROLIINA
Entity Type:Individual
Prefix:
First Name:MAIJU
Middle Name:KAROLIINA
Last Name:BOELE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MAIJU
Other - Middle Name:KAROLIINA
Other - Last Name:KARKKAINEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9471 BLACKLEY ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-3158
Mailing Address - Country:US
Mailing Address - Phone:626-375-4013
Mailing Address - Fax:
Practice Address - Street 1:9471 BLACKLEY ST
Practice Address - Street 2:
Practice Address - City:TEMPLE CITY
Practice Address - State:CA
Practice Address - Zip Code:91780-3158
Practice Address - Country:US
Practice Address - Phone:626-375-4013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-25
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13763225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics