Individual
CODY J VAN WITTENBERGHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPS
Contact information
Practice address
110 BOSTON ST, SALEM, MA 01970-1402
(978) 505-7112
Mailing address
30 FLINT ST, MARBLEHEAD, MA 01945-3741
(978) 505-7112
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/15/2025
Last updated
05/15/2025
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