Individual
ABIGAIL DYKSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
926 WASHINGTON AVE, HOLLAND, MI 49423-7725
(616) 820-3785
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
6851114402
MI
1041C0700X
Clinical Social Worker
Primary
6801118926
MI
106S00000X
Behavior Technician
—
—
Other
Enumeration date
02/13/2020
Last updated
08/15/2024
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