Individual
MS. NANCY VANDYKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LP, LICSW
Contact information
Practice address
5200 WILLSON RD STE 150, EDINA, MN 55424-1300
(952) 836-2688
(952) 836-2730
Mailing address
5200 WILLSON RD STE 150, EDINA, MN 55424-1300
(952) 836-2688
(952) 836-2730
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP0901
MN
1041C0700X
Clinical Social Worker
LICSW4269
MN
Other
Enumeration date
10/02/2008
Last updated
10/02/2008
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