Healthcare Provider Details

I. General information

NPI: 1801915152
Provider Name (Legal Business Name): MS. JANET L BYARS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ELIZABETH PLACE STE 110
DAYTON OH
45408-9901
US

IV. Provider business mailing address

1 ELIZABETH PLACE STE 110
DAYTON OH
45408-9901
US

V. Phone/Fax

Practice location:
  • Phone: 937-898-2484
  • Fax: 937-771-3288
Mailing address:
  • Phone: 937-898-2484
  • Fax: 937-771-3288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE002454
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: