Individual
DELIZ JIVON BYRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
3751 W MAIN ST, INDEPENDENCE, KS 67301-8446
(620) 331-1748
Mailing address
PO BOX 688, INDEPENDENCE, KS 67301-0688
(620) 331-1748
(620) 332-1940
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2374
KS
101YP2500X
Professional Counselor
4596
OK
Other
Enumeration date
02/14/2008
Last updated
01/09/2015
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