Healthcare Provider Details

I. General information

NPI: 1487335014
Provider Name (Legal Business Name): MICHAL Y BOYARS PH.D., NCSP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2023
Last Update Date: 07/27/2023
Certification Date: 07/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8720 GEORGIA AVE STE 606
SILVER SPRING MD
20910-3602
US

IV. Provider business mailing address

8809 WOODLAND DR
SILVER SPRING MD
20910-2708
US

V. Phone/Fax

Practice location:
  • Phone: 301-565-0534
  • Fax:
Mailing address:
  • Phone: 773-899-0724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number62097
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number06662
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: