Individual
DEREK DELOS SANTOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CASAC T
Contact information
Practice address
764 E 176TH ST, BRONX, NY 10460-4606
(718) 583-5150
Mailing address
764 E 176TH ST, BRONX, NY 10460-4606
(718) 583-5150
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
38783
NY
Other
Enumeration date
01/18/2024
Last updated
01/18/2024
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