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1700258605
DERRICK THOMAS
BOSSIER CITY, LA
NPI
1700258605
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2015-10-30
Last Update Date
2018-05-24
Business Address
DERRICK THOMAS
2601 HOYER ST
BOSSIER CITY, LA 71112
Phone number: 318-703-7382
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Mailing Address
DERRICK THOMAS
2601 HOYER ST
BOSSIER CITY, LA 71112-3425
Phone number: 318-703-7382
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