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1861259772
DERRELL COAKLEY
CONYERS, GA
NPI
1861259772
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
104100000X Social Worker
Additional Taxonomies
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2024-03-06
Last Update Date
2024-03-06
Business Address
DERRELL COAKLEY
1315 MILSTEAD RD NE
CONYERS, GA 30012-3824
Phone number: 443-225-1210
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Mailing Address
DERRELL COAKLEY
1315 MILSTEAD RD NE
CONYERS, GA 30012-3824
Phone number: 443-225-1210
Copy
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