Individual
DERRIEK BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSW
Contact information
Practice address
5663 S REDWOOD RD, SUITE 2, OFFICE 10, TAYLORSVILLE, UT 84123
(801) 742-5851
Mailing address
5663 S REDWOOD RD, SUITE 2, OFFICE 10, TAYLORSVILLE, UT 84123
(801) 742-5851
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
13844125-3502
UT
Other
Enumeration date
04/29/2024
Last updated
04/29/2024
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