Provider Demographics
NPI:1942954177
Name:BOYER, KYLIE M (MS SLP)
Entity Type:Individual
Prefix:
First Name:KYLIE
Middle Name:M
Last Name:BOYER
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3715 WESTBROOK DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-8734
Mailing Address - Country:US
Mailing Address - Phone:803-428-7500
Mailing Address - Fax:843-799-4784
Practice Address - Street 1:2213 W PALMETTO ST UNIT D
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-3909
Practice Address - Country:US
Practice Address - Phone:803-428-7500
Practice Address - Fax:843-799-4784
Is Sole Proprietor?:No
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7864235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist