Provider Demographics
NPI:1003394016
Name:BYRD, DARYL (LISW)
Entity Type:Individual
Prefix:
First Name:DARYL
Middle Name:
Last Name:BYRD
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 CAMERON WAY # 2
Mailing Address - Street 2:
Mailing Address - City:NORTH LIBERTY
Mailing Address - State:IA
Mailing Address - Zip Code:52317-4704
Mailing Address - Country:US
Mailing Address - Phone:319-804-9312
Mailing Address - Fax:
Practice Address - Street 1:555 CAMERON WAY # 2
Practice Address - Street 2:
Practice Address - City:NORTH LIBERTY
Practice Address - State:IA
Practice Address - Zip Code:52317-4704
Practice Address - Country:US
Practice Address - Phone:319-804-9312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-01
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0914341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical