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General NPI Number Information
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NPI Number | 1144183062
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Entity Type | Individual
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Provider Name | JUSTIN LEVON BOYKIN
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Gender | Male
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 2022 N PACEY RD
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City | PHOENIX
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State | AZ
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Zip | 85037-6301
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Country | US
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Telephone | 480-908-9013
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Fax |
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Provider Business Mailing Address
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Address Line | 8829 E DARTMOUTH ST
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City | MESA
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State | AZ
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Zip | 85207-6032
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Country | US
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Telephone | 480-294-4454
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | AZ
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