Individual
DERRECO HALLMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1240 W PEACHTREE ST NW APT 1202, ATLANTA, GA 30309-4735
(404) 579-2390
Mailing address
1240 W PEACHTREE ST NW APT 1202, ATLANTA, GA 30309-4735
(404) 579-2390
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/08/2021
Last updated
04/08/2021
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