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NPI Code Detail

MEDICARE: JENNIFER DYER

MEDICARE: JENNIFER DYER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior AnalystBA61090833WA

General Provider Information

NPI Number : 1114563194
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER DYER
Provider Business Mailing Address
First Line : 542 AMHERST ST STE B
Second Line :
City : NASHUA
State : NH
Zip : 03063-1016
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 20816 44TH AVE W STE 103
Second Line :
City : LYNNWOOD
State : WA
Zip : 98036-7744
Country : US
Telephone Number : 206-376-7549
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/25/2019
Last Update Date : 04/06/2026

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