Individual
BRIANNA RAE BYRD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
400 ROUNDS DR, FENTON, MI 48430-1724
(810) 629-0530
(810) 750-6361
Mailing address
1377 MOTOR PKWY STE 307, ISLANDIA, NY 11749-5258
(631) 580-5200
(631) 824-9335
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5201010956
STATE LICENSE
MI
Enumeration date
07/22/2020
Last updated
07/22/2020
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