MEDICARE: MS. ALVREE SHANON BOYD

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
1	235Z00000X	Speech-Language Pathologist		SC

General Provider Information

NPI Number	:	1811553639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALVREE SHANON BOYD

Provider Business Mailing Address
First Line	:	2875 LAKEWOOD AVE, SW A5
Second Line	:	PMB 1026
City	:	ATLANTA
State	:	GA
Zip	:	30315-7878
Country	:	US
Telephone Number	:	404-475-2567
Fax Number	:

Provider Business Practice Location Address
First Line	:	2875 LAKEWOOD AVE, SW A5
Second Line	:	PMB 1026
City	:	ATLANTA
State	:	GA
Zip	:	30315-7878
Country	:	US
Telephone Number	:	404-475-2567
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2019
Last Update Date	:	07/11/2022

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Directions to “ MS. ALVREE SHANON BOYD ” Practice Location

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