Provider Demographics
NPI:1245036466
Name:BYRD, JOSIE MARIE
Entity type:Individual
Prefix:
First Name:JOSIE
Middle Name:MARIE
Last Name:BYRD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 OAK RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341-3611
Mailing Address - Country:US
Mailing Address - Phone:248-470-2663
Mailing Address - Fax:248-706-6124
Practice Address - Street 1:4121 SAINT AUBIN ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48207-1406
Practice Address - Country:US
Practice Address - Phone:313-483-7078
Practice Address - Fax:248-706-6124
Is Sole Proprietor?:No
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No175T00000XOther Service ProvidersPeer Specialist