Individual
SHELLY DYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
78 W CLOVERDALE DR, SOMERSET, KY 42503-5806
(606) 875-3078
Mailing address
78 W CLOVERDALE DR, SOMERSET, KY 42503-5806
(606) 875-3078
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
201152941
KY
Other
Enumeration date
07/10/2024
Last updated
07/10/2024
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