Provider Demographics
NPI:1891044178
Name:BOIVIN, KATHERINE (HIS)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:
Last Name:BOIVIN
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:BOIVIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:HIS
Mailing Address - Street 1:17201 SAN PEDRO
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232
Mailing Address - Country:US
Mailing Address - Phone:210-402-6141
Mailing Address - Fax:210-924-3211
Practice Address - Street 1:7390 BARLITE BLVD
Practice Address - Street 2:SUITE 325
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78260
Practice Address - Country:US
Practice Address - Phone:210-924-3210
Practice Address - Fax:210-924-3211
Is Sole Proprietor?:No
Enumeration Date:2012-09-02
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80541237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist