Individual
DERRICK BOONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
210 E 25TH ST APT 1FW, NEW YORK, NY 10010-3182
(443) 745-7729
Mailing address
210 E 25TH ST APT 1FW, NEW YORK, NY 10010-3182
(443) 745-7729
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
9014616
NY
Other
Enumeration date
05/19/2016
Last updated
05/19/2016
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