DERRICK PAUL WALLACE

LEXINGTON, KY
NPI1184275802
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
Enumeration Date2019-09-24
Last Update Date2019-09-24
Business Address
Mr. DERRICK PAUL WALLACE
2375 PROFESSIONAL HEIGHTS DR STE 240
LEXINGTON, KY 40503-3040
Phone number: 855-591-0092
Mailing Address
Mr. DERRICK PAUL WALLACE
2275 ROBINSON RENAKER RD
BERRY, KY 41003-8521
Phone number: 859-699-0090