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General NPI Number Information
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NPI Number | 1487855268
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Entity Type | Individual
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Provider Name | KATHLEEN BOYD
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Gender | Female
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 252 S VETERANS BLVD
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City | TUPELO
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State | MS
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Zip | 38804-5022
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Country | US
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Telephone | 662-841-3008
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Fax |
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Provider Business Mailing Address
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Address Line | 371 FOUNTAIN LAKE DR
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City | MEMPHIS
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State | TN
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Zip | 38120-1831
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Country | US
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Telephone | 573-453-0115
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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