Provider Demographics
NPI:1851970131
Name:BOYD, KIA S (PHD)
Entity Type:Individual
Prefix:
First Name:KIA
Middle Name:S
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 1:2105 VISTA OESTE NW STE E1941
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-3693
Mailing Address - Country:US
Mailing Address - Phone:678-249-9549
Mailing Address - Fax:
Practice Address - Street 1:2105 VISTA OESTE NW STE E1941
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-3693
Practice Address - Country:US
Practice Address - Phone:678-249-9549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool