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Individual

SUZANNE M DERRICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LISW-CP

Contact information

Practice address
720 BUNCOMBE ST, EDGEFIELD, SC 29824-1019
(803) 637-9730
Mailing address
PO BOX 993, EDGEFIELD, SC 29824-0993
(803) 637-2366

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
5809
SC

Other

Enumeration date
04/19/2007
Last updated
07/08/2007
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