MEDICARE: DR. VINCENT DAVID DYER PSY.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	2229	AL

General Provider Information

NPI Number	:	1013580257
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VINCENT DAVID DYER PSY.D

Provider Business Mailing Address
First Line	:	8701 PRITCHARD PL
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70118-2260
Country	:	US
Telephone Number	:	504-300-7580
Fax Number	:

Provider Business Practice Location Address
First Line	:	8701 PRITCHARD PL
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70118-2260
Country	:	US
Telephone Number	:	504-300-7580
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2021
Last Update Date	:	07/23/2021

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