Provider Demographics
NPI:1639689003
Name:BOYD, SHARLA (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHARLA
Middle Name:
Last Name:BOYD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6614 BANGOR AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-1504
Mailing Address - Country:US
Mailing Address - Phone:806-535-0399
Mailing Address - Fax:
Practice Address - Street 1:6824 WAYNE AVE STE 1
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-1649
Practice Address - Country:US
Practice Address - Phone:806-414-3616
Practice Address - Fax:806-203-3297
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-11
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32168103T00000X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling