Individual
MARSHA DYKSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
245 W RACE ST, SOMERSET, PA 15501-1922
(814) 443-4891
(814) 443-4898
Mailing address
245 W RACE ST, SOMERSET, PA 15501-1922
(814) 443-4891
(814) 443-4898
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000001750065
—
PA
Enumeration date
10/26/2006
Last updated
07/08/2007
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