Individual provider · NPI-1

Dr. Ronald Harold Boardway, PhD

Psychologist, Clinical · Saint Clair Shores, MI

NPI number1881703858
StatusActive
Last updated in NPPESJun 5, 2019

Details

NPI
1881703858
Entity type
Individual (NPI-1)
Name
Dr. Ronald Harold Boardway
Credential
PhD
Sex
Male
Sole proprietor
No
Enumeration date
Aug 30, 2006
Last updated
Jun 5, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
103TC0700X Psychologist, ClinicalRB008826MIYes

Practice location

19900 E 10 Mile Rd Ste 102
Saint Clair Shores, MI 48080-4412

Phone 586-776-3666 · Fax 586-776-3369

Mailing address

19900 E 10 Mile Rd Ste 102
Saint Clair Shores, MI 48080-4412

Phone 586-776-3666 · Fax 586-776-3369

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