Individual
AUTUMN CIERA BOYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
919 S 2ND AVE, WALLA WALLA, WA 99362-4114
(509) 529-6036
Mailing address
919 S 2ND AVE, WALLA WALLA, WA 99362-4114
(509) 529-6036
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
91-2183448
—
WA
Enumeration date
03/11/2020
Last updated
03/11/2020
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