Individual
CRYSTAL R BOYLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1221 WHIPPLE ST, EAU CLAIRE, WI 54703-5270
(715) 838-3305
Mailing address
PO BOX 1510, EAU CLAIRE, WI 54702-1510
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2957
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1015400
NBCOT CERT
—
05
—
40808900
—
WI
Enumeration date
11/03/2006
Last updated
04/21/2009
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