Individual
DERECK DAVID ESTRADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPMHC
Contact information
Practice address
8495 CRATER LAKE HWY # 116B, WHITE CITY, OR 97503-3011
(541) 826-2111
Mailing address
639 SHADOW WAY, CENTRAL POINT, OR 97502-2526
(541) 414-7383
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C4199
OR
Other
Enumeration date
01/07/2019
Last updated
01/07/2019
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