Individual
DERRICK JAMES DERKSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA CADC CANDIDATE
Contact information
Practice address
5401 SW 29TH ST, OKLAHOMA CITY, OK 73179-7602
(405) 686-7828
(405) 686-7827
Mailing address
716 ROYAL AVE, MIDWEST CITY, OK 73130-2713
(405) 640-5220
(405) 686-7827
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OK
Other
Enumeration date
03/11/2019
Last updated
03/11/2019
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