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NPI Code Detail

MEDICARE: EMILY DWYER

MEDICARE: EMILY DWYER
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
1101YA0400XAddiction (Substance Use Disorder) CounselorLA

General Provider Information

NPI Number : 1922936079
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY DWYER
Provider Business Mailing Address
First Line : 252 BERKSHIRE PL
Second Line :
City : HAUGHTON
State : LA
Zip : 71037-9091
Country : US
Telephone Number : 318-829-8429
Fax Number :
Provider Business Practice Location Address
First Line : 3821 SOUTHERN AVE
Second Line :
City : SHREVEPORT
State : LA
Zip : 71106-1033
Country : US
Telephone Number : 318-946-8157
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2026
Last Update Date : 05/11/2026

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Directions to “ EMILY DWYER ” Practice Location

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