Individual
DERRICK KELVIN BOONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6153 SOUTH FIRST STREET, CHATAIGNIER, LA 70524
(337) 580-4144
Mailing address
6153 SOUTH FIRST STREET, CHATAIGNIER, LA 70524
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
11/28/2017
Last updated
05/18/2018
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