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NPI Code Detail

MEDICARE: AUDREY GRACE DYE

MEDICARE: AUDREY GRACE DYE
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
1106S00000XBehavior TechnicianAZ

General Provider Information

NPI Number : 1437027968
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUDREY GRACE DYE
Provider Business Mailing Address
First Line : 1834 E BASELINE RD STE 101
Second Line :
City : TEMPE
State : AZ
Zip : 85283-1508
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1834 E BASELINE RD STE 101
Second Line :
City : TEMPE
State : AZ
Zip : 85283-1508
Country : US
Telephone Number : 480-458-5001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2025
Last Update Date : 10/27/2025

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Directions to “ AUDREY GRACE DYE ” Practice Location

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