Provider Demographics
NPI:1144595281
Name:BOYD, SHAMEKA L
Entity Type:Individual
Prefix:
First Name:SHAMEKA
Middle Name:L
Last Name:BOYD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHAMEKA
Other - Middle Name:L
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3442 COBBLESTONE DR
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:OK
Mailing Address - Zip Code:73084-3256
Mailing Address - Country:US
Mailing Address - Phone:405-924-3575
Mailing Address - Fax:405-606-7271
Practice Address - Street 1:3442 COBBLESTONE DR
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:OK
Practice Address - Zip Code:73084-3256
Practice Address - Country:US
Practice Address - Phone:405-924-3575
Practice Address - Fax:405-606-7271
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-21
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health