Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | P0001746 | TN |
N | 101YM0800X | Mental Health Counselor | P0001746 | TN |
N | 101YP2500X | Professional Counselor | LPC000262 | TN |
N | 102L00000X | Psychologist | P0001746 | TN |
N | 103T00000X | Psychologist | P0001746 | TN |
N | 103TA0700X | Adult Development & Aging Psychologist | P0001746 | TN |
N | 103TB0200X | Cognitive & Behavioral Psychologist | P0001746 | TN |
N | 103G00000X | Clinical Psychologist | P0001746 | TN |
N | 103TC0700X | Clinical Psychologist | P0001746 | TN |
N | 103TC1900X | Counseling Psychologist | P0001746 | TN |
N | 103TF0000X | Family Psychologist | P0001746 | TN |
N | 103TH0004X | Health Psychologist | P0001746 | TN |
NPI | 1356431407 |
---|---|
Provider Name | Dr. William R. Boyd JR. |
First Address | Dayton, TN 37321-5634 |
Second Address | Dayton, TN 37321-5634 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 08/07/2007 |