# DERRICK LAMAR ANDERSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1821852781
- **Gender:** Man

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106S00000X | Behavior Technician | RBT-24-326706 | CO | Yes |

## Other

- **Enumeration date:** 02/12/2024
- **Last updated:** 02/12/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1790211605 | — | CO |