Provider Demographics
NPI:1285029850
Name:BOYD, MATTHEW WAYNE II
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:WAYNE
Last Name:BOYD
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 N MAIN ST STE 301
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-2133
Mailing Address - Country:US
Mailing Address - Phone:508-863-9360
Mailing Address - Fax:774-250-3069
Practice Address - Street 1:45 N MAIN ST STE 301
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-2133
Practice Address - Country:US
Practice Address - Phone:508-863-9360
Practice Address - Fax:774-250-3069
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-01
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13274101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health