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LOLA BYRD PSY.D.

Clinical Neuropsychologist

Roanoke, Virginia

Provider NPI: 1265403877

Provider Information:
 LOLA  BYRD PSY.D.
Gender: F
Not Sole Proprietor

Practice Location:
2727 ELECTRIC RD SUITE 100 ROANOKE, VA 24018 US
Tel: 540-772-5153  Fax: 540-772-5157

Business Mailing Address:
2727 ELECTRIC RD SUITE 100 ROANOKE, VA 24018 US
Tel: 540-772-5153  Fax: 540-772-5157

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
X103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
VA0810001904
X103TA0700XBehavioral Health & Social Service Providers
Psychologist
VA0810001904
X103TR0400XBehavioral Health & Social Service Providers
Psychologist
VA0810001904

Other Provider Identifiers:

IssuerNumberStateType
RICHMOND MEDICARE00W769L95VA04
R6038402
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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