Individual
DARRELL FRANK CORDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
(678) 212-6343
Mailing address
801 EVERGREEN DR, MONROE, GA 30655-7354
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
MSW006379
GA
101YM0800X
Mental Health Counselor
Primary
MSW006379
GA
Other
Enumeration date
10/30/2014
Last updated
10/30/2014
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