Provider Demographics
NPI:1053807180
Name:BOYLE, ALYSON EVELYN
Entity type:Individual
Prefix:
First Name:ALYSON
Middle Name:EVELYN
Last Name:BOYLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3305 W 144TH AVE UNIT 200
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80023-9483
Mailing Address - Country:US
Mailing Address - Phone:303-284-6569
Mailing Address - Fax:
Practice Address - Street 1:3305 W 144TH AVE UNIT 200
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80023-9483
Practice Address - Country:US
Practice Address - Phone:303-284-6569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-01
Last Update Date:2018-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAS99435724OtherDRIVER'S LICENSE