Provider Demographics
NPI:1740492396
Name:BOYD, SUSAN (MA, LLP)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:BOYD
Suffix:
Gender:
Credentials:MA, LLP
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:TORBA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:22811 GREATER MACK AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-2053
Mailing Address - Country:US
Mailing Address - Phone:586-778-9920
Mailing Address - Fax:
Practice Address - Street 1:22811 GREATER MACK AVE STE 108
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-2053
Practice Address - Country:US
Practice Address - Phone:586-778-9920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6361006790103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist