Provider Demographics
NPI:1821383985
Name:DYER, BRANDY LEE (LMSW)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:LEE
Last Name:DYER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1531 DICK LONAS RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-1259
Mailing Address - Country:US
Mailing Address - Phone:865-602-2983
Mailing Address - Fax:
Practice Address - Street 1:1531 DICK LONAS RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-1259
Practice Address - Country:US
Practice Address - Phone:865-602-2983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW0000007759104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker