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1013595776
DERIK GREEN
VIRGINIA BEACH, VA
NPI
1013595776
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor Mental Health
(Licence: VA 0734002974)
Enumeration Date
2021-04-01
Last Update Date
2021-04-01
Business Address
MR. DERIK GREEN MSW, QMHP-T
291 INDEPENDENCE BLVD STE 532
VIRGINIA BEACH, VA 23462-5473
Phone number: 757-962-6889
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Mailing Address
MR. DERIK GREEN MSW, QMHP-T
291 INDEPENDENCE BLVD STE 532
VIRGINIA BEACH, VA 23462-5473
Phone number: 757-962-6889
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