Provider Demographics
NPI:1053617142
Name:BOYD, STEPHANIE LYNN (MED)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:LYNN
Last Name:BOYD
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2815 COLISEUM CENTRE DR
Mailing Address - Street 2:SUITE 230
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28217-1452
Mailing Address - Country:US
Mailing Address - Phone:704-357-7920
Mailing Address - Fax:704-357-7921
Practice Address - Street 1:2815 COLISEUM CENTRE DR
Practice Address - Street 2:SUITE 230
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28217-1452
Practice Address - Country:US
Practice Address - Phone:704-357-7920
Practice Address - Fax:704-357-7921
Is Sole Proprietor?:No
Enumeration Date:2011-02-07
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health