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1225496888
DERICK JEROME HARDY
LAKE CHARLES, LA
NPI
1225496888
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
102L00000X Psychoanalyst
Enumeration Date
2016-02-10
Last Update Date
2022-05-11
Business Address
Mr. DERICK JEROME HARDY Masters
1202 KIRKMAN ST STE A
LAKE CHARLES, LA 70601-5391
Phone number: 337-419-3586
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Mailing Address
Mr. DERICK JEROME HARDY Masters
6027 CANDICE LN
LAKE CHARLES, LA 70615-4773
Phone number: 337-404-1721
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