Provider Demographics
NPI:1457506032
Name:DYER, RHEA LORENN (MS-CCC/SLP)
Entity Type:Individual
Prefix:
First Name:RHEA
Middle Name:LORENN
Last Name:DYER
Suffix:
Gender:F
Credentials:MS-CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 2 BOX 322
Mailing Address - Street 2:
Mailing Address - City:MOUNT CLARE
Mailing Address - State:WV
Mailing Address - Zip Code:26408-9730
Mailing Address - Country:US
Mailing Address - Phone:304-566-7524
Mailing Address - Fax:304-622-2029
Practice Address - Street 1:RR 2 BOX 322
Practice Address - Street 2:
Practice Address - City:MOUNT CLARE
Practice Address - State:WV
Practice Address - Zip Code:26408-9730
Practice Address - Country:US
Practice Address - Phone:304-566-7524
Practice Address - Fax:304-622-2029
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-24
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVSLP-1220235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist