Individual
DEREKA SAMUEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHCA
Contact information
Practice address
417 ARNOLD CT, KOKOMO, IN 46902-3702
(765) 450-4843
Mailing address
417 ARNOLD CT, KOKOMO, IN 46902-3702
(765) 450-4843
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
SAMU-HM8NB8
IN
Other
Enumeration date
03/19/2025
Last updated
03/19/2025
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