Individual
DEREK DOUGLAS
Active
Individual
DEREK DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPSGT, CNA, FCMT, BS
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
—
—
246Z00000X
Other Specialist/Technologist
Primary
24531
CO
247200000X
Other Technician
—
—
374K00000X
Religious Nonmedical Practitioner
—
—
374U00000X
Home Health Aide
NA.00764940
CO
376K00000X
Nurse's Aide
NA.00764940
CO
Other
Enumeration date
04/27/2023
Last updated
08/18/2023
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