Healthcare Provider Details

I. General information

NPI: 1407476922
Provider Name (Legal Business Name): SHARLITA REBECCA BOYD LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2020
Last Update Date: 04/24/2020
Certification Date: 04/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10411 MOTOR CITY DR
BETHESDA MD
20817-1008
US

IV. Provider business mailing address

10411 MOTOR CITY DR
BETHESDA MD
20817-1008
US

V. Phone/Fax

Practice location:
  • Phone: 703-552-2722
  • Fax:
Mailing address:
  • Phone: 703-552-2722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number24956
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: