Provider Demographics
NPI:1275268419
Name:BOYD, CORA ANN (LMHC)
Entity Type:Individual
Prefix:
First Name:CORA
Middle Name:ANN
Last Name:BOYD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7615 VIA COMETA SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87121-2336
Mailing Address - Country:US
Mailing Address - Phone:505-903-9603
Mailing Address - Fax:
Practice Address - Street 1:7615 VIA COMETA SW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87121-2336
Practice Address - Country:US
Practice Address - Phone:505-903-9603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCTB-2022-0075101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor