Provider Demographics
NPI:1003108788
Name:VANDYKE, VOX BD (MA)
Entity type:Individual
Prefix:MR
First Name:VOX
Middle Name:BD
Last Name:VANDYKE
Suffix:
Gender:
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 DICK DR
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-1109
Mailing Address - Country:US
Mailing Address - Phone:978-407-3133
Mailing Address - Fax:
Practice Address - Street 1:2212 TOM MILLER ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-5381
Practice Address - Country:US
Practice Address - Phone:978-407-3133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-12
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health