Provider Demographics
NPI:1750049516
Name:BOYD, NATSHAYLA TRENAI
Entity Type:Individual
Prefix:
First Name:NATSHAYLA
Middle Name:TRENAI
Last Name:BOYD
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 1:618 SAINT MICHAELS WAY # 618
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-1985
Mailing Address - Country:US
Mailing Address - Phone:757-907-3037
Mailing Address - Fax:
Practice Address - Street 1:618 SAINT MICHAELS WAY # 618
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-1985
Practice Address - Country:US
Practice Address - Phone:757-907-3037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician