Provider Demographics
NPI:1487991212
Name:BOISJOLI, KATHY LYN (MA, LPCC)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:LYN
Last Name:BOISJOLI
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:LYN
Other - Last Name:BOISJOLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6600 FRANCE AVE S STE 418
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-1817
Mailing Address - Country:US
Mailing Address - Phone:651-315-5254
Mailing Address - Fax:
Practice Address - Street 1:6600 FRANCE AVE S STE 418
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-1817
Practice Address - Country:US
Practice Address - Phone:651-315-5254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-14
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health