Individual
ALIA BOYNTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
410 S 2ND ST, PHILADELPHIA, PA 19147-1731
(856) 409-0275
Mailing address
1005 SPRUCE ST APT 3R, PHILADELPHIA, PA 19107-6710
(858) 412-9685
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC019642
PA
225XE0001X
Environmental Modification Occupational Therapist
OC019642
PA
225XM0800X
Mental Health Occupational Therapist
OC019642
PA
Other
Enumeration date
12/27/2023
Last updated
12/27/2023
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