MEDICARE: DR. AMY LYNN DILLREE PHD BCBA

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
1	103TM1800X	Intellectual & Developmental Disabilities Psychologist		TX
2	103K00000X	Behavior Analyst	1192	TX

General Provider Information

NPI Number	:	1902092430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMY LYNN DILLREE PHD BCBA

Provider Business Mailing Address
First Line	:	4019 LAKECLIFF DR
Second Line	:
City	:	HARKER HEIGHTS
State	:	TX
Zip	:	76548-8608
Country	:	US
Telephone Number	:	254-833-3744
Fax Number	:	254-393-1253

Provider Business Practice Location Address
First Line	:	4019 LAKECLIFF DR
Second Line	:
City	:	HARKER HEIGHTS
State	:	TX
Zip	:	76548-8608
Country	:	US
Telephone Number	:	254-833-3744
Fax Number	:	254-393-1253

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/18/2007
Last Update Date	:	12/29/2022

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