Healthcare Provider Details

I. General information

NPI: 1740108869
Provider Name (Legal Business Name): BAYLEIGH BOARDWINE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BAYLEIGH DYE

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13168 MEADOWVIEW SQUARE
MEADOWVIEW VA
24361
US

IV. Provider business mailing address

PO BOX 297
MEADOWVIEW VA
24361-0297
US

V. Phone/Fax

Practice location:
  • Phone: 276-944-3999
  • Fax: 276-944-3882
Mailing address:
  • Phone: 276-496-4492
  • Fax: 276-496-0057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: