Provider Demographics
NPI:1770680175
Name:DYER, REBECCA ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:ANN
Last Name:DYER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3911 SOUTHERN OAKS DR UNIT 3
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-0997
Mailing Address - Country:US
Mailing Address - Phone:910-643-0729
Mailing Address - Fax:910-643-1113
Practice Address - Street 1:2817 REILLY ROAD
Practice Address - Street 2:BUILDING 4-2817
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28317
Practice Address - Country:US
Practice Address - Phone:910-643-0729
Practice Address - Fax:910-643-1113
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31104103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical