Basic Information
| Provider Information | |||||||||
| NPI: | 1992978472 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BOYLES | ||||||||
| FirstName: | DANA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LPC, LMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3031 IH 10 W | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782015159 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2107311300 | ||||||||
| FaxNumber: | 2107311310 | ||||||||
| Practice Location | |||||||||
| Address1: | 3031 IH 10 W | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782015159 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2107311300 | ||||||||
| FaxNumber: | 2107311310 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/07/2008 | ||||||||
| LastUpdateDate: | 04/07/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | 16967 | TX | N | Behavioral Health & Social Service Providers | Counselor | 101YP2500X | 16967 | TX | Y | Behavioral Health & Social Service Providers | Counselor | Professional | 106H00000X | 4804 | TX | N | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.