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1619440104
DERECK DAVID ESTRADA
WHITE CITY, OR
NPI
1619440104
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: OR C4199)
Enumeration Date
2019-01-07
Last Update Date
2019-01-07
Business Address
DERECK DAVID ESTRADA LPMHC
8495 CRATER LAKE HWY # 116B
WHITE CITY, OR 97503-3011
Phone number: 541-826-2111
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Mailing Address
DERECK DAVID ESTRADA LPMHC
639 SHADOW WAY
CENTRAL POINT, OR 97502-2526
Phone number: 541-414-7383
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