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General NPI Number Information
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NPI Number | 1104550375
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Entity Type | Organization
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Legal Business Name | BOYLES FAMILY COUNSELING, LLC
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Dates
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Enumeration Date | 07/13/2022
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Last Update Date | 07/13/2022
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Provider Practice Location Address
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Address Line | 401 E MEMORIAL RD STE 500
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City | OKLAHOMA CITY
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State | OK
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Zip | 73114-2287
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Country | US
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Telephone | 405-531-0726
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Fax | 405-607-1750
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Provider Business Mailing Address
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Address Line | 407 W COVELL RD UNIT 30903
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City | EDMOND
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State | OK
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Zip | 73003-2242
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Country | US
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Telephone | 405-531-0726
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Fax | 405-607-1750
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Authorized Official
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Title or Position | OWNER
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Name | ELIZABETH BOYLES
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Credential | LCSW
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Telephone | 405-531-0726
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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