Provider Demographics
NPI:1528261138
Name:BOYD, GERTRUDE KING (LPC)
Entity type:Individual
Prefix:DR
First Name:GERTRUDE
Middle Name:KING
Last Name:BOYD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:DR
Other - First Name:GERTRUDE
Other - Middle Name:KING
Other - Last Name:BOYD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:4148 HONEYSUCKLE DR
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-2765
Mailing Address - Country:US
Mailing Address - Phone:225-658-9860
Mailing Address - Fax:225-654-6498
Practice Address - Street 1:4148 HONEYSUCKLE DR
Practice Address - Street 2:
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791-2765
Practice Address - Country:US
Practice Address - Phone:225-658-9860
Practice Address - Fax:225-654-6498
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1471101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional