Individual
MRS. MARIA LOUISE DYKSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
926 WASHINGTON AVE STE 210, HOLLAND, MI 49423-7725
(616) 820-3780
(616) 820-3785
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
6401016915
MI
101Y00000X
Counselor
LPC.0014471
CO
101YP2500X
Professional Counselor
Primary
6401016915
MI
101YP2500X
Professional Counselor
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/02/2014
Last updated
12/11/2023
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