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1245710045
DERRICK LEIGHTON CARROLL
LEBANON, MO
NPI
1245710045
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor Professional
(Licence: MO 2015039926)
Enumeration Date
2018-08-21
Last Update Date
2018-08-21
Business Address
DERRICK LEIGHTON CARROLL LPC
860 LYNN ST
LEBANON, MO 65536-3810
Phone number: 888-403-1071
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Mailing Address
DERRICK LEIGHTON CARROLL LPC
1800 COMMUNITY
CLINTON, MO 64735-8804
Phone number: 660-885-8131
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