Basic Information
| Provider Information | |||||||||
| NPI: | 1275827883 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BYRD | ||||||||
| FirstName: | DAVA | ||||||||
| MiddleName: | PATTEN | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MS CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2100 BROOKHAVEN BLVD | ||||||||
| Address2: | |||||||||
| City: | NORMAN | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730723044 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4054471311 | ||||||||
| FaxNumber: | 4052124536 | ||||||||
| Practice Location | |||||||||
| Address1: | 3030 NW EXPRESSWAY | ||||||||
| Address2: | SUITE 809 | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731125474 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4059177160 | ||||||||
| FaxNumber: | 4059177161 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2011 | ||||||||
| LastUpdateDate: | 06/01/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 2296 | OK | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.