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Individual

MS. CHERYL MAX VAN DYKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S.S.A.

Contact information

Practice address
680 HIGH ST STE A, WADSWORTH, OH 44281-1690
(330) 631-2333
Mailing address
680 HIGH ST STE A, WADSWORTH, OH 44281-1690
(330) 631-2333

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I0004177
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
913085
CLINICAL LICENSE
OH
01
I0004177
CLINICAL LICENSE NUMBER
OH
Enumeration date
03/16/2007
Last updated
10/21/2020
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