Individual
DERRICK JAVON FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6939 ROOSEVELT ROAD, 600, CHICAGO, IL 60304
(708) 508-3000
Mailing address
5850 GRANITE PKWY STE 600, PLANO, TX 75024-6753
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/03/2024
Last updated
06/03/2024
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