Provider Demographics
NPI:1881017622
Name:BOYER, NANCY (TEACHER OF THE SPEEC)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:BOYER
Suffix:
Gender:F
Credentials:TEACHER OF THE SPEEC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 28
Mailing Address - Street 2:23 HUSKIE LANE
Mailing Address - City:MALONE
Mailing Address - State:NY
Mailing Address - Zip Code:12953-0028
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:758 COUNTY ROUTE 7
Practice Address - Street 2:
Practice Address - City:BRUSHTON
Practice Address - State:NY
Practice Address - Zip Code:12916-3916
Practice Address - Country:US
Practice Address - Phone:518-529-7324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-30
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2195868812355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY219586881OtherTEACHER LICENSE #