Healthcare Provider Details

I. General information

NPI: 1255270294
Provider Name (Legal Business Name): CAITLIN BOYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 36TH AVE NW UNIT 100
NORMAN OK
73072-3251
US

IV. Provider business mailing address

405 SILL CIR
BLANCHARD OK
73010-6702
US

V. Phone/Fax

Practice location:
  • Phone: 479-318-2172
  • Fax:
Mailing address:
  • Phone: 405-406-3817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: