Provider Demographics
NPI:1790565216
Name:DWYER, ADELAIDE ELIZABETH (MSW)
Entity Type:Individual
Prefix:
First Name:ADELAIDE
Middle Name:ELIZABETH
Last Name:DWYER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 E BYRD ST APT 6113
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23219-4285
Mailing Address - Country:US
Mailing Address - Phone:757-556-5696
Mailing Address - Fax:
Practice Address - Street 1:8545 PATTERSON AVE
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23229-6455
Practice Address - Country:US
Practice Address - Phone:757-603-4603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program