Provider Demographics
NPI:1902574239
Name:BOYD, JADA MARI (DPT)
Entity Type:Individual
Prefix:
First Name:JADA
Middle Name:MARI
Last Name:BOYD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 HELMSMAN CT
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21221-2902
Mailing Address - Country:US
Mailing Address - Phone:443-928-9182
Mailing Address - Fax:
Practice Address - Street 1:3700 FLEET ST STE 109
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-4238
Practice Address - Country:US
Practice Address - Phone:443-438-7214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-01
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD28629225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist