MEDICARE: DR. KATE BOYLE PSY. D, L.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	LP4428	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	50957B0	OTHER	MN	BC/BS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659370278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATE BOYLE PSY. D, L.P.

Provider Business Mailing Address
First Line	:	241 CLEVELAND AVE S STE A7
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55105-1200
Country	:	US
Telephone Number	:	651-698-3393
Fax Number	:	888-978-4418

Provider Business Practice Location Address
First Line	:	241 CLEVELAND AVE S STE A7
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55105-1200
Country	:	US
Telephone Number	:	651-698-3393
Fax Number	:	888-978-4418

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	07/20/2023

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