Provider Demographics
NPI:1306052857
Name:BOYLE, JULIE (BCBA, ITDS)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:BOYLE
Suffix:
Gender:F
Credentials:BCBA, ITDS
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:PROTOPAPA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1920 SPANISH OAKS DR S
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-6642
Mailing Address - Country:US
Mailing Address - Phone:727-282-3234
Mailing Address - Fax:727-213-6246
Practice Address - Street 1:12413 WHITE BLUFF RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34669-5016
Practice Address - Country:US
Practice Address - Phone:727-741-3405
Practice Address - Fax:727-213-6246
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000561200Medicaid