Provider Demographics
NPI:1306328331
Name:BOYKIN, MONTOYA LEAK
Entity type:Individual
Prefix:MS
First Name:MONTOYA
Middle Name:LEAK
Last Name:BOYKIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 SOUTH MAIN STREET
Mailing Address - Street 2:SUITE 607
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44308
Mailing Address - Country:US
Mailing Address - Phone:330-701-8982
Mailing Address - Fax:
Practice Address - Street 1:133 SOUTH MAIN STREET
Practice Address - Street 2:SUITE 607
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44308
Practice Address - Country:US
Practice Address - Phone:330-701-8982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-06
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator