Individual
DR. ERIC J. DYKSTRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D
Contact information
Practice address
7086 8TH AVE, JENISON, MI 49428-9352
(616) 667-9551
Mailing address
7086 8TH AVE, JENISON, MI 49428-9352
(616) 667-9551
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301013027
MI
103TB0200X
Cognitive & Behavioral Psychologist
6301013027
MI
103TC0700X
Clinical Psychologist
6301013027
MI
103TC2200X
Clinical Child & Adolescent Psychologist
6301013027
MI
103TM1800X
Intellectual & Developmental Disabilities Psychologist
6301013027
MI
Other
Enumeration date
12/13/2006
Last updated
10/06/2023
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