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NPI Code Detail

MEDICARE: LADAE BOYKIN

MEDICARE: LADAE BOYKIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1205553732
Entity Type Code : Individual
Provider Name (Legal Business Name) : LADAE BOYKIN
Provider Business Mailing Address
First Line : 7350 W CENTENNIAL PKWY UNIT 1068
Second Line :
City : LAS VEGAS
State : NV
Zip : 89131-1634
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6180 BRENT THURMAN WAY STE 100
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-5018
Country : US
Telephone Number : 702-813-3437
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2022
Last Update Date : 11/07/2024

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Directions to “ LADAE BOYKIN ” Practice Location

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