Provider Demographics
NPI:1932615887
Name:DYER, MELINDA RUTH
Entity Type:Individual
Prefix:MS
First Name:MELINDA
Middle Name:RUTH
Last Name:DYER
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:MELINDA
Other - Middle Name:RUTH
Other - Last Name:LAYFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:118 STOVER DR
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-8601
Mailing Address - Country:US
Mailing Address - Phone:740-369-6811
Mailing Address - Fax:740-363-8742
Practice Address - Street 1:118 STOVER DR
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-8601
Practice Address - Country:US
Practice Address - Phone:740-369-6811
Practice Address - Fax:740-363-8742
Is Sole Proprietor?:No
Enumeration Date:2017-12-14
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS13266101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional