Provider Demographics
NPI:1558806877
Name:DYER, BETSY ALLISON (COTA/L)
Entity type:Individual
Prefix:
First Name:BETSY
Middle Name:ALLISON
Last Name:DYER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 ACADEMY RD
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04259-7037
Mailing Address - Country:US
Mailing Address - Phone:207-739-9519
Mailing Address - Fax:
Practice Address - Street 1:169 ACADEMY RD
Practice Address - Street 2:
Practice Address - City:MONMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04259-7037
Practice Address - Country:US
Practice Address - Phone:207-739-9519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-21
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOA3223224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant