Individual
DEREK ANDREW GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW, LADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
000391
VT
1041C0700X
Clinical Social Worker
Primary
089.0000978
VT
Other
Enumeration date
05/24/2011
Last updated
05/24/2011
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