Provider Demographics
NPI:1154026623
Name:DYER, ANNA JEANNE (MA, LPC)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:JEANNE
Last Name:DYER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 EDENS AVE
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-4110
Mailing Address - Country:US
Mailing Address - Phone:469-431-2794
Mailing Address - Fax:
Practice Address - Street 1:207 EDENS AVE
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-4110
Practice Address - Country:US
Practice Address - Phone:469-431-2794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-03
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80660101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health