Individual
DAVID MARTIN DERENGOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8200 GEORGIA ST, MERRILLVILLE, IN 46410-6227
(219) 791-1400
Mailing address
8200 GEORGIA ST, MERRILLVILLE, IN 46410-6227
(219) 791-1400
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
88001658A
IN
Other
Enumeration date
01/05/2024
Last updated
01/05/2024
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