Provider Demographics
NPI:1003449653
Name:BOYD, SARAH DULCE
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:DULCE
Last Name:BOYD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:DULCE PALOMA
Other - Last Name:MOYA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:707 BROADWAY BLVD NE STE 500
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-2367
Mailing Address - Country:US
Mailing Address - Phone:505-268-0701
Mailing Address - Fax:
Practice Address - Street 1:707 BROADWAY BLVD NE STE 500
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-2367
Practice Address - Country:US
Practice Address - Phone:505-268-0701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-21
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist