Provider Demographics
NPI:1336039205
Name:BOYLE, TAYLOR MICHELLE
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:MICHELLE
Last Name:BOYLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58162 ASH RD
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA
Mailing Address - State:IN
Mailing Address - Zip Code:46561-9635
Mailing Address - Country:US
Mailing Address - Phone:574-575-1127
Mailing Address - Fax:
Practice Address - Street 1:1920 E MCKINLEY AVE
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-7206
Practice Address - Country:US
Practice Address - Phone:888-717-5835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician