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Individual

LISHA BOYD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Taxonomy

Speciality
Code
Description
License number
State
174200000X
Meals Provider
Primary
4769242
OH
175T00000X
Peer Specialist
OH
347C00000X
Private Vehicle
4769242
OH

Other

Enumeration date
03/27/2024
Last updated
04/19/2024
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