Individual
DERRICK THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2601 HOYER ST, BOSSIER CITY, LA 71112
(318) 703-7382
Mailing address
2601 HOYER ST, BOSSIER CITY, LA 71112-3425
(318) 703-7382
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/30/2015
Last updated
05/24/2018
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