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1437821790
DERRICK WHITE
STATEN ISLAND, NY
NPI
1437821790
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NY 37149)
Enumeration Date
2021-10-04
Last Update Date
2021-10-04
Business Address
DERRICK WHITE CASAC-T,CRPA
3911 RICHMOND AVE
STATEN ISLAND, NY 10312-5110
Phone number: 718-948-3232
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Mailing Address
DERRICK WHITE CASAC-T,CRPA
321 ODER AVE
STATEN ISLAND, NY 10304-3327
Phone number: 917-674-9368
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