Provider Demographics
NPI:1629839527
Name:BYRD, RON'L MARIE (COTA/L)
Entity Type:Individual
Prefix:
First Name:RON'L
Middle Name:MARIE
Last Name:BYRD
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 ALVIN CT
Mailing Address - Street 2:
Mailing Address - City:ORONOGO
Mailing Address - State:MO
Mailing Address - Zip Code:64855-8202
Mailing Address - Country:US
Mailing Address - Phone:417-540-7974
Mailing Address - Fax:
Practice Address - Street 1:5507 W WALSH LN STE 201
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8995
Practice Address - Country:US
Practice Address - Phone:280-647-9367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant