Provider Demographics
NPI:1457121295
Name:DYER, AALIYAH NICOLE (BCABA)
Entity Type:Individual
Prefix:MRS
First Name:AALIYAH
Middle Name:NICOLE
Last Name:DYER
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15206 WILD MEADOW PL
Mailing Address - Street 2:
Mailing Address - City:LEO
Mailing Address - State:IN
Mailing Address - Zip Code:46765-9589
Mailing Address - Country:US
Mailing Address - Phone:260-385-6166
Mailing Address - Fax:
Practice Address - Street 1:2270 LAKE AVE
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46805-5359
Practice Address - Country:US
Practice Address - Phone:260-444-5649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst