Provider Demographics
NPI:1972650901
Name:BOBBITT-BOYCE, EDITH (MS, CCC-A)
Entity Type:Individual
Prefix:
First Name:EDITH
Middle Name:
Last Name:BOBBITT-BOYCE
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 E WOODHURST DR
Mailing Address - Street 2:SUITE Q-100
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-4257
Mailing Address - Country:US
Mailing Address - Phone:417-881-1010
Mailing Address - Fax:417-887-4327
Practice Address - Street 1:1200 E WOODHURST DR
Practice Address - Street 2:SUITE Q-100
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-4257
Practice Address - Country:US
Practice Address - Phone:417-881-1010
Practice Address - Fax:417-887-4327
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006034976231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1134206550OtherGROUP NPI