Individual
DEREK DOMONIQUE BALTIMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2041 MARTIN LUTHER KING JR AVE SE, WASHINGTON, DC 20020-7024
(202) 547-8540
Mailing address
2239 FARRINGTON AVE APT 202, ALEXANDRIA, VA 22303-1543
(202) 699-5310
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/01/2024
Last updated
10/01/2024
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