Individual
DEREK COLVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BHRS
Contact information
Practice address
1732 S KELLY AVE, EDMOND, OK 73013-3630
(405) 642-5320
Mailing address
7405 NW 121ST ST, OKLAHOMA CITY, OK 73162-1518
(405) 642-5320
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7201
OK
Other
Enumeration date
06/19/2012
Last updated
02/07/2020
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