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1144515248
DERRICK ELTON CRIM
MINNEAPOLIS, MN
NPI
1144515248
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MN 300252)
Enumeration Date
2011-06-16
Last Update Date
2011-06-16
Business Address
-- DERRICK ELTON CRIM LADC
1911 PLEASANT AVE
MINNEAPOLIS, MN 55403-3506
Phone number: 612-874-9811
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Mailing Address
-- DERRICK ELTON CRIM LADC
1911 PLEASANT AVE
MINNEAPOLIS, MN 55403-3506
Phone number: 612-874-9811
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