Provider Demographics
NPI:1508371105
Name:BYERS, AMANDA LEE
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:LEE
Last Name:BYERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6351 BROWN RD
Mailing Address - Street 2:
Mailing Address - City:KENOCKEE
Mailing Address - State:MI
Mailing Address - Zip Code:48006-2609
Mailing Address - Country:US
Mailing Address - Phone:810-289-8741
Mailing Address - Fax:
Practice Address - Street 1:110 N SAGINAW ST STE 3
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-4600
Practice Address - Country:US
Practice Address - Phone:810-535-5587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-06
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician