Healthcare Provider Details

I. General information

NPI: 1154126910
Provider Name (Legal Business Name): CHRISTIANNE BOYLE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2025
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10807 PERRIN BEITEL RD
SAN ANTONIO TX
78217-3143
US

IV. Provider business mailing address

8911 BRAE BND
SAN ANTONIO TX
78249-4154
US

V. Phone/Fax

Practice location:
  • Phone: 210-245-7862
  • Fax:
Mailing address:
  • Phone: 830-388-1514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number91485
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: