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Individual
MR. DERRIK RICHARD HAITHCOCK SR.
Active
Individual
MR. DERRIK RICHARD HAITHCOCK SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCDC LLL
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDCIII.161470
OH
171M00000X
Case Manager/Care Coordinator
—
NULL
Other
Enumeration date
05/14/2018
Last updated
04/10/2019
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