Pamela L Boyd

Individual provider Active NPI Intellectual and/or Developmental Disabilities Residential Treatment Facility · Winterville, NC

NPI 1104608678 · NPPES record last updated Oct 18, 2023

Key facts

NPI
1104608678
Entity type
Individual (NPI type 1)
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
Practice address
2928 Fox Glove Dr
Winterville, NC 28590-7119
Phone
(804) 677-0020
NPI assigned
Oct 18, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pastoral Counselor 101YP1600X
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Yes

Addresses

Primary practice location

2928 Fox Glove Dr
Winterville, NC 28590-7119

Mailing address

2928 Fox Glove Dr
Winterville, NC 28590-7119
Phone (804) 677-0020

Other providers in Winterville, NC

All providers in Winterville, NC · Intellectual and/or Developmental Disabilities Residential Treatment Facility in North Carolina

Sources for this page

Verify at the official NPI Registry.