Individual
DERWIN MANIGAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8303 OVERHILL DR, POMONA, NY 10970-3808
(845) 659-1355
Mailing address
8303 OVERHILL DR, POMONA, NY 10970-3808
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/07/2022
Last updated
03/07/2022
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