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Individual

KELLY BYRER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
861 HAROLD PL, SUITE 205, CHULA VISTA, CA 91914-4553
(619) 578-2232
(619) 578-2231
Mailing address
7850 MISSION CENTER CT, SUITE 100, SAN DIEGO, CA 92108-1322
(619) 578-2232
(619) 578-2231

Taxonomy

Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SPA 3664
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
330965547
ADDIE'S AUTISM FITT CLUB
CA
Enumeration date
02/29/2016
Last updated
02/29/2016
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