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NPI Code Detail

MEDICARE: PAUL BRUCE BYRD PH.D.

MEDICARE:   PAUL BRUCE BYRD  PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC1900XCounseling Psychologist308375-2501UT

General Provider Information

NPI Number : 1801854237
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL BRUCE BYRD PH.D.
Provider Business Mailing Address
First Line : 2315 S SCENIC BLVD
Second Line :
City : SPOKANE
State : WA
Zip : 99224-4704
Country : US
Telephone Number : 509-570-6575
Fax Number :
Provider Business Practice Location Address
First Line : 2315 S SCENIC BLVD
Second Line :
City : SPOKANE
State : WA
Zip : 99224-4704
Country : US
Telephone Number : 509-570-6575
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2006
Last Update Date : 07/08/2007

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Directions to “ PAUL BRUCE BYRD PH.D.” Practice Location

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