Provider Demographics
NPI:1770721805
Name:BOYD, RUTH ELAINE (SLP-CCC)
Entity type:Individual
Prefix:
First Name:RUTH
Middle Name:ELAINE
Last Name:BOYD
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4105 BRIGGS CHANEY RD
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20705-1040
Mailing Address - Country:US
Mailing Address - Phone:301-802-3859
Mailing Address - Fax:
Practice Address - Street 1:4105 BRIGGS CHANEY RD
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-1040
Practice Address - Country:US
Practice Address - Phone:301-802-3859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-27
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03681235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist