Provider Demographics
NPI:1871756635
Name:BYRD, SUSAN SANDERS (AUD)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:SANDERS
Last Name:BYRD
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 REDBUD TRL
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39047-6403
Mailing Address - Country:US
Mailing Address - Phone:601-613-3893
Mailing Address - Fax:
Practice Address - Street 1:151 E METRO DR STE 201
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-4405
Practice Address - Country:US
Practice Address - Phone:601-973-1680
Practice Address - Fax:601-973-1681
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSA0920231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist