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1336856939
DERRICK DWAYNE NELSON
NORTHRIDGE, CA
NPI
1336856939
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2022-11-02
Last Update Date
2022-11-02
Business Address
DERRICK DWAYNE NELSON
8330 RESEDA BLVD
NORTHRIDGE, CA 91324-4619
Phone number: 818-996-1051
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Mailing Address
DERRICK DWAYNE NELSON
8330 RESEDA BLVD
NORTHRIDGE, CA 91324-4619
Phone number: 818-996-1051
Copy
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