Individual
ADALEA PEARL DYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
625 EAGLE WALK RD, DELAWARE, OH 43015-7246
(614) 906-8786
Mailing address
161 GEORGETOWN DR, DELAWARE, OH 43015-1532
(419) 731-1540
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
TK798136
OH
372500000X
Chore Provider
—
—
376J00000X
Homemaker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TK798136
DRIVERS LICENSE
OH
Enumeration date
12/29/2020
Last updated
12/29/2020
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