Individual
MRS. VANESSA DYKSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
46181 272ND ST, CHANCELLOR, SD 57015-5320
(605) 413-5614
Mailing address
46181 272ND ST, CHANCELLOR, SD 57015-5320
(605) 413-5614
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3583
SD
Other
Enumeration date
03/19/2019
Last updated
03/19/2019
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