Provider Demographics
NPI:1386423069
Name:BYERS), MONICA LEE (SLP)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:LEE
Last Name:BYERS)
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3564 E 2ND ST UNIT 71
Mailing Address - Street 2:
Mailing Address - City:THE DALLES
Mailing Address - State:OR
Mailing Address - Zip Code:97058-9687
Mailing Address - Country:US
Mailing Address - Phone:541-993-0208
Mailing Address - Fax:
Practice Address - Street 1:802 NE 5TH ST
Practice Address - Street 2:
Practice Address - City:DUFUR
Practice Address - State:OR
Practice Address - Zip Code:97021-3034
Practice Address - Country:US
Practice Address - Phone:541-467-2509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR01114592235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist