Healthcare Provider Details

I. General information

NPI: 1336340652
Provider Name (Legal Business Name): THOMAS JOSEPH BOYLE M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 07/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2820 W ROSE GARDEN LN
PHOENIX AZ
85027-3108
US

IV. Provider business mailing address

525 W FLYNN LN
PHOENIX AZ
85013-1116
US

V. Phone/Fax

Practice location:
  • Phone: 623-445-3020
  • Fax:
Mailing address:
  • Phone: 623-445-3020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: