Provider Demographics
NPI:1417463076
Name:BYRD, AMANDA (BCBA, COBA)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:BYRD
Suffix:
Gender:F
Credentials:BCBA, COBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7264 COLUMBIA RD
Mailing Address - Street 2:
Mailing Address - City:MAINEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45039-8085
Mailing Address - Country:US
Mailing Address - Phone:513-963-0519
Mailing Address - Fax:833-301-0427
Practice Address - Street 1:7264 COLUMBIA RD
Practice Address - Street 2:
Practice Address - City:MAINEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45039-8085
Practice Address - Country:US
Practice Address - Phone:513-963-0519
Practice Address - Fax:833-301-0427
Is Sole Proprietor?:No
Enumeration Date:2017-12-19
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
OHCOBA.00768103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician