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1902950736
DERRICK MICHAEL MOORE
JACKSON, MS
NPI
1902950736
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
104100000X Social Worker
(Licence: MS C6782)
Enumeration Date
2007-01-22
Last Update Date
2024-11-27
Business Address
Mr. DERRICK MICHAEL MOORE LMSW
1500 E. WOODROW WILSON DR.
JACKSON, MS 39216-5199
Phone number: 601-362-4471
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Mailing Address
Mr. DERRICK MICHAEL MOORE LMSW
5354 KEELE ST
JACKSON, MS 39206-4106
Phone number: 601-454-2080
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