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General NPI Number Information
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NPI Number | 1629866009
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Entity Type | Individual
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Provider Name | RACHEL DYER
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Gender | Female
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Dates
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Enumeration Date | 04/28/2025
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 7818 BIG SKY DR
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City | MADISON
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State | WI
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Zip | 53719-3524
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Country | US
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Telephone | 804-676-1095
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Fax |
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Provider Business Mailing Address
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Address Line | W6157 ROCK ISLAND DR
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City | GREENVILLE
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State | WI
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Zip | 54942-8792
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Country | US
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Telephone | 262-215-8091
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Fax |
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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 | 5342-57
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License Number State | WI
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