Provider Demographics
NPI:1679717300
Name:BOYD, MOLLY A (SLA-BA)
Entity type:Individual
Prefix:MS
First Name:MOLLY
Middle Name:A
Last Name:BOYD
Suffix:
Gender:F
Credentials:SLA-BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72936-7007
Mailing Address - Country:US
Mailing Address - Phone:479-996-4142
Mailing Address - Fax:479-996-4143
Practice Address - Street 1:300 WESTWOOD AVE
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:AR
Practice Address - Zip Code:72936-4921
Practice Address - Country:US
Practice Address - Phone:479-996-7748
Practice Address - Fax:479-996-7846
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-24
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant