Provider Demographics
NPI:1396533642
Name:BOYNE, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:BOYNE
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 1:4041 N HIGH ST STE 102
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3248
Mailing Address - Country:US
Mailing Address - Phone:614-931-0228
Mailing Address - Fax:
Practice Address - Street 1:30 W WOODRUFF AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1118
Practice Address - Country:US
Practice Address - Phone:614-931-0228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLSP.02324103TS0200X
OHSP.00766103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool