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Individual

DERRICK DE SOTO

Active
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Individual

DERRICK DE SOTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Taxonomy

Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
RN74889
HI

Other

Enumeration date
08/05/2015
Last updated
08/05/2015
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