Provider Demographics
NPI:1861703324
Name:BOYCE, KIRBY BYRD (MCD, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KIRBY
Middle Name:BYRD
Last Name:BOYCE
Suffix:
Gender:F
Credentials:MCD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 TIMBERLAKE DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-9312
Mailing Address - Country:US
Mailing Address - Phone:843-230-0515
Mailing Address - Fax:843-393-7599
Practice Address - Street 1:201 TIMBERLAKE DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-9312
Practice Address - Country:US
Practice Address - Phone:843-230-0515
Practice Address - Fax:843-393-7599
Is Sole Proprietor?:No
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4046235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC2424Medicaid