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Individual

TARANIIO ANTONIO BYRD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
295 HOSPITAL ST, MOULTON, AL 35650-1210
(256) 355-6105
Mailing address
1316 SOMERVILLE RD SE, SUITE 1, DECATUR, AL 35601-4305
(256) 355-6105

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1041C0700X
Clinical Social Worker
Primary
2392C
AL

Other

Enumeration date
04/19/2010
Last updated
07/05/2011
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