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General NPI Number Information
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NPI Number | 1598957557
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Entity Type | Individual
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Provider Name | AMANDA DIX DYER PH.D.
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Gender | Female
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Dates
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Enumeration Date | 08/14/2007
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Last Update Date | 06/04/2021
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Provider Practice Location Address
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Address Line | 47 GREENSBORO HWY STE 3
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City | WATKINSVILLE
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State | GA
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Zip | 30677-2515
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Country | US
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Telephone | 706-410-4074
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Fax | 706-664-0459
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Provider Business Mailing Address
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Address Line | PO BOX 1125
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City | WATKINSVILLE
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State | GA
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Zip | 30677-0024
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Country | US
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Telephone | 706-410-4074
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Fax | 706-664-0459
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 3109
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License Number State | GA
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