Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FX1201X | Optometric Assistant | ||
N | 170100000X | Medical Geneticist | ||
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1871789552 |
---|---|
Provider Name | Bethany Ann Dyer |
First Address | Syracuse, NY 13210-1912 |
Second Address | Syracuse, NY 13210-1912 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2007 |
Last Update Date | 19/04/2018 |