Mary Kaitlyn Boley, M.S. CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Anna, TX
NPI 1164072872 · NPPES record last updated Sep 14, 2019
Key facts
- NPI
- 1164072872
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 110916 (TX)
- Practice address
- 2121 Sweet Gum Dr
Anna, TX 75409-0117 - Phone
- (214) 837-3608
- NPI assigned
- Sep 14, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110916 | TX | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 110916 | TX | Yes |
Addresses
Primary practice location
2121 Sweet Gum Dr
Anna, TX 75409-0117
Mailing address
2121 Sweet Gum Dr
Anna, TX 75409-0117
Phone (214) 837-3608
Other names
- Mary Kaitlyn Gerber
Other providers in Anna, TX
- Whitney Bauman
- Kimberly Joy Beard
- Sheri Bennett
- Seema Bhakta
- Brandon Boley
- Branches Dental, PLLC
- Lauren Elizabeth Brock
- Alexandra Brooks
- Brookshire Grocery Company
- Hannah Brown
All providers in Anna, TX · Speech-Language Pathologist in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.