Provider Demographics
NPI:1245968726
Name:DYE, MACY FOSTER (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MACY
Middle Name:FOSTER
Last Name:DYE
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 1:118 EDGEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:BANDERA
Mailing Address - State:TX
Mailing Address - Zip Code:78003-4285
Mailing Address - Country:US
Mailing Address - Phone:940-839-9686
Mailing Address - Fax:
Practice Address - Street 1:118 EDGEWOOD CIR
Practice Address - Street 2:
Practice Address - City:BANDERA
Practice Address - State:TX
Practice Address - Zip Code:78003-4285
Practice Address - Country:US
Practice Address - Phone:940-839-9686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117053235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist