Individual
DERRIK ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
249 BILLINGSLEY RD, CHARLOTTE, NC 28211-1003
(704) 336-4679
(704) 331-0859
Mailing address
249 BILLINGSLEY RD, CHARLOTTE, NC 28211-1003
(704) 336-4679
(704) 331-0859
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P002691
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15112
HEALTH DEPARTMENT
NC
Enumeration date
09/27/2006
Last updated
07/08/2007
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