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General NPI Number Information
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NPI Number | 1861292047
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Entity Type | Individual
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Provider Name | CAROLINE MICHELLE DYER OTD, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 03/17/2025
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 128 SOUTHWINDS RD STE 7
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City | FARMINGTON
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State | AR
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Zip | 72730-8685
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Country | US
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Telephone | 479-267-2777
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Fax |
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Provider Business Mailing Address
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Address Line | 708 N ANNA PL
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City | FAYETTEVILLE
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State | AR
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Zip | 72701-2556
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Country | US
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Telephone | 501-352-8576
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OTR4062
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License Number State | AR
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