Provider Demographics
NPI:1154554574
Name:BOYD, TOMMIE V (PHD)
Entity type:Individual
Prefix:DR
First Name:TOMMIE
Middle Name:V
Last Name:BOYD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10208 NW 5TH ST
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1642
Mailing Address - Country:US
Mailing Address - Phone:954-474-2572
Mailing Address - Fax:954-262-3968
Practice Address - Street 1:1830 N PINE ISLAND RD
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-5202
Practice Address - Country:US
Practice Address - Phone:954-292-2126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-02
Last Update Date:2019-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT1741106H00000X, 106H00000X
SCLMF 1048106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist