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General NPI Number Information
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NPI Number | 1669743571
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Entity Type | Individual
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Provider Name | MELISSA MUNRO BOYD PSYD
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Gender | Female
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Dates
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Enumeration Date | 01/24/2012
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Last Update Date | 05/13/2013
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Provider Practice Location Address
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Address Line | 10580 ARROWHEAD DR FORT BELVOIR COMMUNITY HOSPITAL
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City | FAIRFAX
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State | VA
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Zip | 22030
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Country | US
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Telephone | 571-432-2685
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Fax |
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Provider Business Mailing Address
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Address Line | 7510 BURDETTE WAY
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City | BELTSVILLE
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State | MD
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Zip | 20705-6314
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Country | US
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Telephone | 215-983-6366
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 04986
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License Number State | MD
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