MEDICARE: DR. DEBRA LYNNE BOYD PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	PS017391	PA

General Provider Information

NPI Number	:	1467705855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBRA LYNNE BOYD PH.D.

Provider Business Mailing Address
First Line	:	226 RUTLEDGE AVE
Second Line	:
City	:	RUTLEDGE
State	:	PA
Zip	:	19070-2119
Country	:	US
Telephone Number	:	713-505-0482
Fax Number	:

Provider Business Practice Location Address
First Line	:	4883 W CHESTER PIKE
Second Line	:
City	:	NEWTOWN SQUARE
State	:	PA
Zip	:	19073-2213
Country	:	US
Telephone Number	:	610-383-0239
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/22/2012
Last Update Date	:	03/09/2022

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