Provider Demographics
NPI:1588034839
Name:BYARS, AMELIA
Entity Type:Individual
Prefix:
First Name:AMELIA
Middle Name:
Last Name:BYARS
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 1:431 W MECHANIC ST
Mailing Address - Street 2:
Mailing Address - City:GEFF
Mailing Address - State:IL
Mailing Address - Zip Code:62842-1072
Mailing Address - Country:US
Mailing Address - Phone:618-516-2366
Mailing Address - Fax:
Practice Address - Street 1:431 W MECHANIC ST
Practice Address - Street 2:
Practice Address - City:GEFF
Practice Address - State:IL
Practice Address - Zip Code:62842-1072
Practice Address - Country:US
Practice Address - Phone:618-516-2366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-30
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.0035292355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant