Tyler Michael Dwyer, CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Graham, NC

NPI 1104555895 · NPPES record last updated Jun 7, 2022

Key facts

NPI
1104555895
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
14586 (NC)
Practice address
215 College St
Graham, NC 27253-2206
Phone
(352) 281-8893
NPI assigned
Jun 7, 2022
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
14586NCMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 14586 NC Yes

Addresses

Primary practice location

215 College St
Graham, NC 27253-2206

Mailing address

215 College St
Graham, NC 27253-2206

Other identifiers

IdentifierTypeStateIssuer
14586OtherNCNC SLP LICENSE

Other providers in Graham, NC

All providers in Graham, NC · Speech-Language Pathologist in North Carolina

Sources for this page

Verify at the official NPI Registry.