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General NPI Number Information
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NPI Number | 1578621488
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Entity Type | Individual
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Provider Name | SUSAN R BYRD MA,LPC
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Gender | Female
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 14114 DALLAS PKWY STE 260
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City | DALLAS
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State | TX
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Zip | 75254-1316
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Country | US
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Telephone | 972-774-0221
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Fax | 972-774-0544
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Provider Business Mailing Address
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Address Line | 14902 PRESTON RD STE 404 # 302
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City | DALLAS
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State | TX
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Zip | 75254-9105
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Country | US
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Telephone | 214-796-6177
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Fax | 972-774-0544
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 15139
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License Number State | TX
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