Individual
DERRICK BLACKWELL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2759 MARTIN LUTHER KING JR AVE SE, WASHINGTON, DC 20032-2646
(202) 827-9961
Mailing address
2750 LORRING DR APT 301, DISTRICT HEIGHTS, MD 20747-3438
(202) 549-4362
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/08/2023
Last updated
05/08/2023
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