Provider Demographics
NPI:1467787283
Name:DYER, AMY RULAND (LPC)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:RULAND
Last Name:DYER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 YORK DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2065
Mailing Address - Country:US
Mailing Address - Phone:972-331-8739
Mailing Address - Fax:972-331-8748
Practice Address - Street 1:3028 LAVITA LN
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75234-6423
Practice Address - Country:US
Practice Address - Phone:214-669-1002
Practice Address - Fax:972-488-3978
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-13
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63830101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional