Individual
SANDRA DYKSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSSW
Contact information
Practice address
8018 W CAPITOL DR UNIT 6, MILWAUKEE, WI 53222-1906
(414) 559-8864
Mailing address
2342 N 61ST ST, WAUWATOSA, WI 53213-1504
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
126837-121
WI
Other
Enumeration date
01/30/2016
Last updated
01/30/2016
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