Healthcare Provider Details

I. General information

NPI: 1073199717
Provider Name (Legal Business Name): MS. CHRISTINA MARIE BYRD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2021
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 MARKET ST STE 200
CHAPEL HILL NC
27516-4493
US

IV. Provider business mailing address

7108 S KANNER HWY
STUART FL
34997-7462
US

V. Phone/Fax

Practice location:
  • Phone: 984-528-8787
  • Fax: 984-246-1223
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-22-57768
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number4556
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: