Healthcare Provider Details

I. General information

NPI: 1417878257
Provider Name (Legal Business Name): ASHLEY SUE BYRD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 S KYRENE RD UNIT 231
CHANDLER AZ
85226-4489
US

IV. Provider business mailing address

255 S KYRENE RD UNIT 231 UNIT 231
CHANDLER AZ
85226-4489
US

V. Phone/Fax

Practice location:
  • Phone: 605-639-1171
  • Fax:
Mailing address:
  • Phone: 605-639-1171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSLPA17356
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: