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1720340920
DEREK DISPONETTE
LOUISVILLE, KY
NPI
1720340920
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2012-06-13
Last Update Date
2012-06-13
Business Address
-- DEREK DISPONETTE
2210 TUCKER STATION RD
LOUISVILLE, KY 40299-4525
Phone number: 502-589-8600
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Mailing Address
-- DEREK DISPONETTE
101 W MUHAMMAD ALI BLVD
LOUISVILLE, KY 40202-1423
Phone number:
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