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Individual
MR. DEREK A WARD
Active
Individual
MR. DEREK A WARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA LMHC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0128201
NM
Other
Enumeration date
04/12/2011
Last updated
04/12/2011
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