Individual
DERRICK EDMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3901 ULLOA ST, NEW ORLEANS, LA 70119
(504) 267-5712
Mailing address
3901 ULLOA ST, NEW ORLEANS, LA 70119-6942
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/04/2015
Last updated
06/05/2018
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