Individual
MAUREEN JEANNETTE VANDYKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
9311
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9205014000
—
WV
Enumeration date
11/28/2007
Last updated
11/28/2007
Update your record
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