DERRICK JACK

NEW ALBANY, IN
NPI1265096994
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: IN  34012719A)
Enumeration Date2019-04-29
Last Update Date2026-03-11
Business Address
DERRICK JACK LCSW
2627 CHARLESTOWN RD
NEW ALBANY, IN 47150-2536
Phone number: 812-944-1550
Mailing Address
DERRICK JACK LCSW
2008 ELDER PARK RD
LA GRANGE, KY 40031-9302
Phone number:
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