Individual
WANDA THEODOSIA BOYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
29520 CANVASBACK DR, EASTON, MD 21601-7124
(410) 822-5007
(410) 334-6362
Mailing address
2336 GODDARD PKWY, SALISBURY, MD 21801-1126
(410) 334-6961
(410) 334-6362
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
520202701
—
MD
05
—
609500301
—
MD
05
—
609500304
—
MD
Enumeration date
06/14/2016
Last updated
09/20/2016
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