Individual
DERICA WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
8089 S LINCOLN ST, SUITE 203, LITTLETON, CO 80122-2700
(303) 915-5567
Mailing address
8089 S LINCOLN ST, SUITE 203, LITTLETON, CO 80122-2700
(303) 915-5567
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
83
CO
Other
Enumeration date
02/06/2007
Last updated
07/08/2007
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