Healthcare Provider Details

I. General information

NPI: 1689013237
Provider Name (Legal Business Name): KIERA BOYLE-TOLEDO PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KIERA BOYLE PSYD

II. Dates (important events)

Enumeration Date: 06/17/2013
Last Update Date: 10/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 VETERANS MEMORIAL PKWY
RIVERSIDE RI
02915-5061
US

IV. Provider business mailing address

117 ELLENFIELD ST STE 101
PROVIDENCE RI
02905-4513
US

V. Phone/Fax

Practice location:
  • Phone: 401-432-1000
  • Fax:
Mailing address:
  • Phone: 972-849-2025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number003476
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS01623
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: