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1962019273
DERRICK KIRK
ALEXANDRIA, LA
NPI
1962019273
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor Mental Health
Enumeration Date
2020-09-30
Last Update Date
2020-09-30
Business Address
DERRICK KIRK
3600 JACKSON ST STE 111B
ALEXANDRIA, LA 71303-3000
Phone number: 318-483-4155
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Mailing Address
DERRICK KIRK
3600 JACKSON ST STE 11B
ALEXANDRIA, LA 71303-3040
Phone number:
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