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Individual

MR. BENJAMIN DAVID DERRICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BIBLICAL COUNSELOR

Contact information

Practice address
4500 INTERSTATE 55 NORTH FRONTAGE RD, STE 279, JACKSON, MS 39211
(601) 405-7445
Mailing address
173 BUCKHEAD DR, MADISON, MS 39110-6615
(601) 405-7440

Taxonomy

Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
10102004
MS

Other

Enumeration date
03/08/2022
Last updated
03/08/2022
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