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Individual

MR. KENDRICK G DYER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
3278 MITCHELL BLVD, MOODY AFB, GA 31699-1500
(229) 257-4805
Mailing address
3280 MITCHELL BLVD MOODY AFB GA 31699, MOODY AFB, GA 31699-0001
(229) 257-2778

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
004323
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
004323
LICENSE
GA
Enumeration date
03/14/2011
Last updated
04/02/2025
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  • EDI platform