GLEN ALLEN DERRA

SANFORD, NC
NPI1780534834
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: NC  P023351)
Enumeration Date2026-01-29
Last Update Date2026-01-29
Business Address
GLEN ALLEN DERRA
130 CARBONTON RD
SANFORD, NC 27330-4009
Phone number: 919-774-6521
Mailing Address
GLEN ALLEN DERRA
284 EXECUTIVE PARK DR STE 100
CONCORD, NC 28025-1833
Phone number: 704-939-1100
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