Individual
MYKL BOYD-RASKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1115 5TH ST, SIOUX CITY, IA 51101-1905
(712) 255-0890
Mailing address
2801 JENNINGS ST, SIOUX CITY, IA 51104-3626
(712) 899-8362
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
05/23/2022
Last updated
05/23/2022
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