Individual
CHERYL MARIE VAN DYKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1129 MACON DR, TITUSVILLE, FL 32780-7715
(912) 674-8379
Mailing address
1129 MACON DR, TITUSVILLE, FL 32780-7715
(912) 674-8379
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC007689
GA
Other
Enumeration date
02/17/2021
Last updated
02/17/2021
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