Provider Demographics
NPI:1083580351
Name:BOYLE, GRACE (BCBA; LBA)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:BOYLE
Suffix:
Gender:F
Credentials:BCBA; LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 ROSEMARY DR
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852-1811
Mailing Address - Country:US
Mailing Address - Phone:269-370-8703
Mailing Address - Fax:
Practice Address - Street 1:26 OLIPHANT LN
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842-4659
Practice Address - Country:US
Practice Address - Phone:401-849-2122
Practice Address - Fax:401-849-0202
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-14
Last Update Date:2025-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILBA00494103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty