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Individual

IMANI RENEE BYRD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
TLLP

Contact information

Practice address
229 N SHELDON RD, PLYMOUTH, MI 48170
(313) 278-4601
Mailing address
229 N SHELDON RD, PLYMOUTH, MI 48170-1524
(313) 278-4601

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301017396
MI
103TB0200X
Cognitive & Behavioral Psychologist
103TC2200X
Clinical Child & Adolescent Psychologist

Other

Enumeration date
11/15/2018
Last updated
01/28/2019
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