Individual
LAURIN DERRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1485 INTERNATIONAL PARKWAY, SUITE #2051, HEATHROW, FL 32746
(800) 798-6035
Mailing address
1485 INTERNATIONAL PARKWAY, SUITE #2051, HEATHROW, FL 32746
(800) 798-6035
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4044
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4044
AZ LICENSE #
AZ
Enumeration date
03/04/2008
Last updated
03/04/2008
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