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1982475125
DERRICK ELLIS
LOS ANGELES, CA
NPI
1982475125
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2024-01-15
Last Update Date
2024-01-15
Business Address
DERRICK ELLIS
155 BIMINI PL
LOS ANGELES, CA 90004-5902
Phone number: 213-388-5423
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Mailing Address
DERRICK ELLIS
155 BIMINI PL
LOS ANGELES, CA 90004-5902
Phone number: 213-388-5423
Copy
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