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General NPI Number Information
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NPI Number | 1669708574
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Entity Type | Individual
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Provider Name | WILLIAM LEWIS BOYD MA, NCC
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Gender | Male
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Dates
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Enumeration Date | 10/28/2009
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Last Update Date | 10/28/2009
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Provider Practice Location Address
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Address Line | 315 N LAKEMONT AVE
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City | WINTER PARK
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State | FL
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Zip | 32792-3205
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Country | US
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Telephone | 407-830-6412
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Fax |
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Provider Business Mailing Address
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Address Line | 206 S VIRGINIA AVE
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City | SANFORD
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State | FL
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Zip | 32771-1559
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Country | US
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Telephone | 407-474-7898
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | IMH 3051
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License Number State | FL
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