Healthcare Provider Details

I. General information

NPI: 1235046962
Provider Name (Legal Business Name): JONI BOYD PHD, RDN, CSCS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3066 DENALI WAY
ROCK HILL SC
29732-7653
US

IV. Provider business mailing address

3066 DENALI WAY
ROCK HILL SC
29732-7653
US

V. Phone/Fax

Practice location:
  • Phone: 803-487-6129
  • Fax:
Mailing address:
  • Phone: 803-487-6129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLRD.3777RD
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: