Provider Demographics
NPI:1194432161
Name:BOYD, BAILEY (BCBA, LABA)
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:
Last Name:BOYD
Suffix:
Gender:F
Credentials:BCBA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17826 JUNEBERRY SEED ST
Mailing Address - Street 2:
Mailing Address - City:HOCKLEY
Mailing Address - State:TX
Mailing Address - Zip Code:77447-2353
Mailing Address - Country:US
Mailing Address - Phone:318-840-2299
Mailing Address - Fax:
Practice Address - Street 1:5400 MITCHELLDALE ST STE C1
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-7233
Practice Address - Country:US
Practice Address - Phone:281-715-2888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-31
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5421103K00000X
TX6150103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst