Healthcare Provider Details

I. General information

NPI: 1205756889
Provider Name (Legal Business Name): SYDNEE MAKAY BYERS
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 11TH AVE S STE 155
NAMPA ID
83651-3946
US

IV. Provider business mailing address

3685 S CREEKWOOD WAY
BOISE ID
83709-6072
US

V. Phone/Fax

Practice location:
  • Phone: 208-466-1077
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number3181827
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: