DERRICK ELLIS

LOS ANGELES, CA
NPI1982475125
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2024-01-15
Last Update Date2024-01-15
Business Address
DERRICK ELLIS
155 BIMINI PL
LOS ANGELES, CA 90004-5902
Phone number: 213-388-5423
Mailing Address
DERRICK ELLIS
155 BIMINI PL
LOS ANGELES, CA 90004-5902
Phone number: 213-388-5423