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General NPI Number Information
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NPI Number | 1508954439
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Entity Type | Individual
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Provider Name | ELIZABETH SHRYER BOYLE PSYD, LP
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Gender | Female
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 05/25/2017
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Provider Practice Location Address
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Address Line | 1599 SELBY AVENUE SUITE 103
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City | ST. PAUL
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State | MN
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Zip | 55105
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Country | US
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Telephone | 651-789-4746
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Fax | 651-393-5423
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Provider Business Mailing Address
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Address Line | 1599 SELBY AVE SUITE 103
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City | ST. PAUL
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State | MN
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Zip | 55104
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Country | US
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Telephone | 651-789-4746
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Fax | 651-393-5423
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | LP3254
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | LP3254
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License Number State | MN
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