Provider Demographics
NPI:1891390431
Name:BOYER, ROD (LPC)
Entity Type:Individual
Prefix:
First Name:ROD
Middle Name:
Last Name:BOYER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 SHELLEY DR
Mailing Address - Street 2:
Mailing Address - City:CANYON
Mailing Address - State:TX
Mailing Address - Zip Code:79015-5005
Mailing Address - Country:US
Mailing Address - Phone:806-433-9650
Mailing Address - Fax:
Practice Address - Street 1:1035 SHELLEY DR
Practice Address - Street 2:
Practice Address - City:CANYON
Practice Address - State:TX
Practice Address - Zip Code:79015-5005
Practice Address - Country:US
Practice Address - Phone:806-433-9650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12505101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional