Provider Demographics
NPI:1194089847
Name:BOYLL, ALICIA (BCBA)
Entity type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:
Last Name:BOYLL
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5027 BROOKSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-5416
Mailing Address - Country:US
Mailing Address - Phone:317-514-0442
Mailing Address - Fax:
Practice Address - Street 1:5027 BROOKSTONE WAY
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-5416
Practice Address - Country:US
Practice Address - Phone:317-514-0442
Practice Address - Fax:888-643-8335
Is Sole Proprietor?:No
Enumeration Date:2012-06-27
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst