DERICK ALLEN EIDSON

ADA, OK
NPI1811339294
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2013-07-25
Last Update Date2013-07-25
Business Address
-- DERICK ALLEN EIDSON
19108 COUNTY ROAD 3560
ADA, OK 74820-0177
Phone number: 580-421-1800
Mailing Address
-- DERICK ALLEN EIDSON
19108 COUNTY ROAD 3560
ADA, OK 74820-0177
Phone number: 580-421-1800
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