Healthcare Provider Details

I. General information

NPI: 1447471016
Provider Name (Legal Business Name): OLIVIA BOYLE BURCH M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: OLIVIA SUSAN BOYLE M.S., CCC-SLP

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 TEN ROD RD STE C104
N KINGSTOWN RI
02852-4127
US

IV. Provider business mailing address

4 QUAIL CT
EAST GREENWICH RI
02818-1569
US

V. Phone/Fax

Practice location:
  • Phone: 401-404-5585
  • Fax:
Mailing address:
  • Phone: 401-487-0562
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP01969
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: