Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003256918 |
---|---|
Provider Name | Tammy Boyd |
First Address | Lawton, OK 73505-5239 |
Second Address | Lawton, OK 73505-5239 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2013 |
Last Update Date | 23/05/2014 |