Provider Demographics
NPI:1750071106
Name:BYRD, ERICKA
Entity type:Individual
Prefix:
First Name:ERICKA
Middle Name:
Last Name:BYRD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ERICKA
Other - Middle Name:
Other - Last Name:BEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2635 FIVE STAR CT
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-8543
Mailing Address - Country:US
Mailing Address - Phone:470-214-8454
Mailing Address - Fax:
Practice Address - Street 1:2635 FIVE STAR CT
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30039-8543
Practice Address - Country:US
Practice Address - Phone:470-214-8454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Q00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Pathology
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No171400000XOther Service ProvidersHealth & Wellness Coach
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No171W00000XOther Service ProvidersContractor
No172A00000XOther Service ProvidersDriver
No175F00000XOther Service ProvidersNaturopath
No225500000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/Technologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program