Individual
DONNA MARIE DYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
58 PINE ST, NEW CANAAN, CT 06840-5425
(203) 966-9997
Mailing address
58 PINE ST, NEW CANAAN, CT 06840
(203) 966-9997
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
004641
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140004641CT02
BLUE CROSS
CT
Enumeration date
12/28/2006
Last updated
03/11/2008
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