Provider Demographics
NPI:1043900889
Name:BOYKIN, KRESHAYLA K (LMT)
Entity type:Individual
Prefix:MS
First Name:KRESHAYLA
Middle Name:K
Last Name:BOYKIN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48342-3339
Mailing Address - Country:US
Mailing Address - Phone:248-818-5338
Mailing Address - Fax:
Practice Address - Street 1:158 RUSSELL ST
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48342-3339
Practice Address - Country:US
Practice Address - Phone:248-818-5338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-12
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility