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General NPI Number Information
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NPI Number | 1699479386
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Entity Type | Individual
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Provider Name | SUMMER BOYD PSYD
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Gender | Female
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Dates
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Enumeration Date | 03/28/2023
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Last Update Date | 12/04/2023
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Provider Practice Location Address
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Address Line | 2225 N 16TH ST
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City | PHOENIX
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State | AZ
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Zip | 85006-1823
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Country | US
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Telephone | 602-340-8717
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Fax | 602-606-9870
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Provider Business Mailing Address
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Address Line | 2225 N 16TH ST
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City | PHOENIX
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State | AZ
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Zip | 85006-1823
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Country | US
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Telephone | 602-340-8717
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Fax | 602-606-9870
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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 | PSY-005656
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY-005656
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License Number State | AZ
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