Individual
BREE ELIZABETH DERRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CAGS, LMHC
Contact information
Practice address
347 BROADWAY, PROVIDENCE, RI 02909-1101
(401) 301-2504
Mailing address
347 BROADWAY, PROVIDENCE, RI 02909-1101
(401) 301-2504
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MCH00486
RI
Other
Enumeration date
02/20/2012
Last updated
02/20/2012
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