Individual
MISS VIRGINIA BOYKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS LBSC
Contact information
Practice address
824 S 57TH ST, PHILADELPHIA, PA 19143-2702
(610) 659-1491
Mailing address
824 S 57TH ST, PHILADELPHIA, PA 19143-2702
(610) 659-1491
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH000271
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0
—
PA
Enumeration date
12/23/2014
Last updated
12/23/2014
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