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Individual

DERRICK J. KIRKLAND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
6100 CHANNINGWAY BLVD STE 6016100, COLUMBUS, OH 43232-2910
(614) 626-8538
Mailing address
4258 CONOVER PL, COLUMBUS, OH 43227-2443
(614) 980-7902

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
00251
OH
175T00000X
Peer Specialist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1437699543
OH
Enumeration date
12/09/2021
Last updated
05/07/2024
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