Individual
DORRIS H VAN DYKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
425 BROADWAY ST, PADUCAH, KY 42001-0713
(240) 442-7121
Mailing address
425 BROADWAY, PADUCAH, KY 45200
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
104255
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KY-0571
LPCC
KY
Enumeration date
12/19/2006
Last updated
06/10/2024
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