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Individual
MICHAEL ALLEN VANSLYKE
Active
Individual
MICHAEL ALLEN VANSLYKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA, LISAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-10197
AZ
Other
Enumeration date
06/18/2010
Last updated
06/18/2010
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