Provider Demographics
NPI:1538840541
Name:DYER, AMY LEIGH (LMSW)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LEIGH
Last Name:DYER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-6534
Mailing Address - Country:US
Mailing Address - Phone:314-762-8100
Mailing Address - Fax:314-552-7539
Practice Address - Street 1:1 COUNTRY RD
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-6534
Practice Address - Country:US
Practice Address - Phone:314-324-3835
Practice Address - Fax:314-552-7539
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022048816104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker