Individual
MS. BRENDA W DYKSTRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
410 ROEDL CT, BEAVER DAM, WI 53916-2934
(920) 887-7191
(920) 887-7270
Mailing address
410 ROEDL CT, BEAVER DAM, WI 53916-2934
(920) 887-7191
(920) 887-7270
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3894-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40851500
—
WI
Enumeration date
04/23/2008
Last updated
04/23/2008
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