Provider Demographics
NPI:1689753667
Name:BOYD, NAUGHNE LA VONNE (PH D)
Entity Type:Individual
Prefix:DR
First Name:NAUGHNE
Middle Name:LA VONNE
Last Name:BOYD
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 ALEXANDER AVE
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99354-1649
Mailing Address - Country:US
Mailing Address - Phone:509-946-9613
Mailing Address - Fax:509-943-6814
Practice Address - Street 1:2401 ALEXANDER AVE
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354-1649
Practice Address - Country:US
Practice Address - Phone:509-946-9613
Practice Address - Fax:509-943-6814
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA460103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA460OtherSTATE PSYCHOLOGY LICENSE#
WA602224729OtherUBI #
WA207744001OtherEMPLOYMENT SECURITY REF#
WA421545402OtherEIN
WA602224729OtherUBI #