Individual
MR. DERRICK EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC-MHSP
Contact information
Practice address
963 GWYNN LN, LEBANON, TN 37087-9448
(615) 403-3639
Mailing address
963 GWYNN LN, LEBANON, TN 37087-9448
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3159
TN
Other
Enumeration date
09/11/2014
Last updated
09/11/2014
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