Provider Demographics
NPI:1740322247
Name:BYRD, GAY LYN (MED)
Entity type:Individual
Prefix:MRS
First Name:GAY
Middle Name:LYN
Last Name:BYRD
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4625 FAWN RUN DR
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-2336
Mailing Address - Country:US
Mailing Address - Phone:405-410-5047
Mailing Address - Fax:888-523-6071
Practice Address - Street 1:200 S RANCHWOOD BLVD STE 17
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-2743
Practice Address - Country:US
Practice Address - Phone:405-410-5047
Practice Address - Fax:888-523-6071
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2977235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist