Healthcare Provider Details

I. General information

NPI: 1144909797
Provider Name (Legal Business Name): NATALIE JEAN DYER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2023
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1571 BLUFF SPRINGS RD
GLASGOW KY
42141-9424
US

IV. Provider business mailing address

1571 BLUFF SPRINGS RD
GLASGOW KY
42141-9424
US

V. Phone/Fax

Practice location:
  • Phone: 270-590-9347
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number287656
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: