Provider Demographics
NPI:1184428112
Name:BOYLE, EMMA DEEANN
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:DEEANN
Last Name:BOYLE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5530 PAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45414-3365
Mailing Address - Country:US
Mailing Address - Phone:937-607-5702
Mailing Address - Fax:
Practice Address - Street 1:5530 PAYNE AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45414-3365
Practice Address - Country:US
Practice Address - Phone:937-607-5702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty