MEDICARE: MS. TRAON BOYKIN M.S., CCC-SLP

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	235Z00000X	Speech-Language Pathologist	07533	MD

General Provider Information

NPI Number	:	1497226211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TRAON BOYKIN M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	PO BOX 6855
Second Line	:
City	:	CAPITOL HEIGHTS
State	:	MD
Zip	:	20791-6855
Country	:	US
Telephone Number	:	301-455-7668
Fax Number	:

Provider Business Practice Location Address
First Line	:	5200 MARLBORO PIKE
Second Line	:
City	:	CAPITOL HEIGHTS
State	:	MD
Zip	:	20743-5424
Country	:	US
Telephone Number	:	301-817-2933
Fax Number	:

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

Provider Enumeration Date	:	12/06/2018
Last Update Date	:	12/06/2018

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