Provider Demographics
NPI:1356942775
Name:BOYCE, KHALINA
Entity type:Individual
Prefix:
First Name:KHALINA
Middle Name:
Last Name:BOYCE
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 1:3753 KATIE PL
Mailing Address - Street 2:
Mailing Address - City:TRIANGLE
Mailing Address - State:VA
Mailing Address - Zip Code:22172-2044
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8000 TOWERS CRESCENT DRIVE
Practice Address - Street 2:13TH FLOOR
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182
Practice Address - Country:US
Practice Address - Phone:833-599-2560
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician