Individual
CHRISTOPHER R VANDYKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., BCBA
Contact information
Practice address
1575 ALLOUEZ AVE, GREEN BAY, WI 54311-5639
(920) 857-9041
(920) 857-3366
Mailing address
1575 ALLOUEZ AVE, GREEN BAY, WI 54311-5639
(920) 857-9041
(920) 857-3366
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
8690-125
WI
103K00000X
Behavior Analyst
Primary
144-140
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
144-140
WI LICENSE
WI
Enumeration date
04/14/2016
Last updated
06/13/2023
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