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1063677052
DERRICK MEDEARIS
BERLIN, NJ
NPI
1063677052
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2008-07-19
Last Update Date
2008-07-19
Business Address
-- DERRICK MEDEARIS
128 CROSS KEYS RD
BERLIN, NJ 08009-9201
Phone number: 856-210-1511
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Mailing Address
-- DERRICK MEDEARIS
128 CROSS KEYS RD
BERLIN, NJ 08009-9201
Phone number: 856-210-1511
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