Individual
JENNIFER DERRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7330 FERN AVE STE 1003, SHREVEPORT, LA 71105-4988
(318) 759-7876
Mailing address
7330 FERN AVE STE 1003, SHREVEPORT, LA 71105-4988
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/09/2021
Last updated
01/04/2022
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