Provider Demographics
NPI:1578621819
Name:BYRD, SHELLY MARLENE (MENTAL HEALTH WORKER)
Entity Type:Individual
Prefix:MISS
First Name:SHELLY
Middle Name:MARLENE
Last Name:BYRD
Suffix:
Gender:F
Credentials:MENTAL HEALTH WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:592 RIO LINDO AVE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-1817
Mailing Address - Country:US
Mailing Address - Phone:530-891-2775
Mailing Address - Fax:
Practice Address - Street 1:592 RIO LINDO AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-1817
Practice Address - Country:US
Practice Address - Phone:530-891-2775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor