Individual
KILLIAN JAMES DERUSHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
1311 WAKARUSA DR STE 2100, LAWRENCE, KS 66049-4775
(785) 424-7770
(785) 843-2219
Mailing address
1311 WAKARUSA DR STE 2100, LAWRENCE, KS 66049-4775
(785) 843-2219
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
10470
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3004349890002
—
KS
Enumeration date
06/21/2017
Last updated
10/27/2022
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