Mr Brandon Boyd, | |
901 S Huntington St, Syracuse, IN 46567-1923 | |
(800) 342-5653 | |
Not Available |
Full Name | Mr Brandon Boyd |
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Gender | Male |
Speciality | Counselor - Mental Health |
Location | 901 S Huntington St, Syracuse, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1073017422 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YM0800X | Counselor - Mental Health | 88001517A (Indiana) | Primary |
Entity Name | The Otis R Bowen Center For Human Services Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1639172810 PECOS PAC ID: 7618950965 Enrollment ID: O20050404000853 |
Mailing Address | Practice Location Address |
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Mr Brandon Boyd, 2621 E Jefferson St, Warsaw, IN 46580-3880 Ph: () - | Mr Brandon Boyd, 901 S Huntington St, Syracuse, IN 46567-1923 Ph: (800) 342-5653 |
Hope Owens, Counselor Medicare: Not Enrolled in Medicare Practice Location: 901 S Huntington St, Syracuse, IN 46567 Phone: 574-457-4400 Fax: 574-457-4141 | |
Jamie Jacobs, Counselor Medicare: Not Enrolled in Medicare Practice Location: 901 S Huntington St, Syracuse, IN 46567 Phone: 574-457-4400 Fax: 574-457-4141 | |
Maria Valeria Guzman, Counselor Medicare: Not Enrolled in Medicare Practice Location: 901 S Huntington St, Syracuse, IN 46567 Phone: 574-457-4400 | |
Shane M. Bullick, MA Counselor Medicare: Medicare Enrolled Practice Location: 901 S Huntington St, Syracuse, IN 46567 Phone: 574-457-4400 | |
Stephen Gall, MSED Counselor Medicare: Not Enrolled in Medicare Practice Location: 901 S Huntington St, Syracuse, IN 46567 Phone: 574-457-4400 Fax: 574-457-4141 | |
Alicia Nolan, MSED Counselor Medicare: Not Enrolled in Medicare Practice Location: 901 S Huntington St, Syracuse, IN 46567 Phone: 574-457-4400 |