Healthcare Provider Details

I. General information

NPI: 1871172171
Provider Name (Legal Business Name): KRISTIN OBOYLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 PAOLI POINTE DR
PAOLI PA
19301-2104
US

IV. Provider business mailing address

600 PAOLI POINTE DR
PAOLI PA
19301-2104
US

V. Phone/Fax

Practice location:
  • Phone: 215-734-3861
  • Fax:
Mailing address:
  • Phone: 215-734-3861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOC017347
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: