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General NPI Number Information
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NPI Number | 1861089518
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Entity Type | Individual
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Provider Name | ADALEA PEARL DYER
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Gender | Female
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Dates
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Enumeration Date | 12/29/2020
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Last Update Date | 12/29/2020
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Provider Practice Location Address
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Address Line | 625 EAGLE WALK RD
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City | DELAWARE
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State | OH
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Zip | 43015-7246
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Country | US
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Telephone | 614-906-8786
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Fax |
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Provider Business Mailing Address
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Address Line | 161 GEORGETOWN DR
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City | DELAWARE
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State | OH
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Zip | 43015-1532
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Country | US
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Telephone | 419-731-1540
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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 | 372500000X
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Taxonomy Name | Chore Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | TK798136
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License Number State | OH
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