MEDICARE: ANDRIA BOYKIN

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	103K00000X	Behavior Analyst	1-22-58202
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1659845360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDRIA BOYKIN

Provider Business Mailing Address
First Line	:	9 BANKS AVE
Second Line	:
City	:	MCADOO
State	:	PA
Zip	:	18237-2508
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2221 BROADBIRCH DR
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-1932
Country	:	US
Telephone Number	:	570-802-3099
Fax Number	:

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

Provider Enumeration Date	:	01/15/2019
Last Update Date	:	03/03/2022

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Directions to “ ANDRIA BOYKIN ” Practice Location

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