Provider Demographics
NPI:1396026761
Name:BOYKIN, DAMICA D
Entity Type:Individual
Prefix:MRS
First Name:DAMICA
Middle Name:D
Last Name:BOYKIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1019 FELIX PALM AVE
Mailing Address - Street 2:
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-0269
Mailing Address - Country:US
Mailing Address - Phone:702-276-5668
Mailing Address - Fax:
Practice Address - Street 1:1019 FELIX PALM AVE
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-0269
Practice Address - Country:US
Practice Address - Phone:702-330-6099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-30
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty