Provider Demographics
NPI:1043910045
Name:BOYD, TANYA DAVIS (LMSW)
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:DAVIS
Last Name:BOYD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3540 THUNDERWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-5688
Mailing Address - Country:US
Mailing Address - Phone:678-887-4281
Mailing Address - Fax:
Practice Address - Street 1:3540 THUNDERWOOD LN
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30039-5688
Practice Address - Country:US
Practice Address - Phone:678-887-4281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW007614104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker