Provider Demographics
NPI:1235417379
Name:BOYD, REGINA (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:BOYD
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-2954
Mailing Address - Country:US
Mailing Address - Phone:321-345-9129
Mailing Address - Fax:
Practice Address - Street 1:165 N 4TH ST
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-2954
Practice Address - Country:US
Practice Address - Phone:321-345-9129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-22
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health