| Amethyst Neuropsychology Pllc | |
|
4505 N Illinois St Ste 7 Swansea IL 62226-1500 | |
| (618) 680-0317 | |
| Not Available |
| Full Name | Amethyst Neuropsychology Pllc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 4505 N Illinois St Ste 7, Swansea, Illinois |
| Authorized Official Name and Position | Sarah M Dyer (CLINICAL NEUROPSYCHOLOGIST) |
| Authorized Official Contact | 6186800317 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amethyst Neuropsychology Pllc 4505 N Illinois St Ste 7 Swansea IL 62226-1500 Ph: (618) 680-0317 | Amethyst Neuropsychology Pllc 4505 N Illinois St Ste 7 Swansea IL 62226-1500 Ph: (618) 680-0317 |
| NPI Number | 1093542904 |
|---|---|
| Provider Enumeration Date | 09/16/2024 |
| Last Update Date | 09/16/2024 |
| Certification Date | 09/16/2024 |
| Medicare PECOS PAC ID | 9830623933 |
|---|---|
| Medicare Enrollment ID | O20241112003394 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093542904 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
| Provider Name | Sarah Mailander Dyer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043877475 PECOS PAC ID: 9638562382 Enrollment ID: I20220202000969 |
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