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Individual
DR. WILLIS T VAN DYNE
Active
Individual
DR. WILLIS T VAN DYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY D
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
006790
NY
Other
Enumeration date
08/21/2006
Last updated
04/15/2008
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