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Individual

DEREK WASHINGTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
165 GALLIVAN BLVD, DORCHESTER CENTER, MA 02124-5503
(617) 251-5954
Mailing address
165 GALLIVAN BLVD, DORCHESTER CENTER, MA 02124-5503
(617) 251-5954

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
03/11/2010
Last updated
03/11/2010
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