Provider Demographics
NPI:1609929637
Name:BYRD, GAIL MARIE (SLP)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:MARIE
Last Name:BYRD
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 WADDLE RICE RD
Mailing Address - Street 2:
Mailing Address - City:SCIENCE HILL
Mailing Address - State:KY
Mailing Address - Zip Code:42553-9215
Mailing Address - Country:US
Mailing Address - Phone:606-423-9538
Mailing Address - Fax:
Practice Address - Street 1:1304 WADDLE RICE RD
Practice Address - Street 2:
Practice Address - City:SCIENCE HILL
Practice Address - State:KY
Practice Address - Zip Code:42553-9215
Practice Address - Country:US
Practice Address - Phone:606-423-9538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1103235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist