Individual
DERRICK FORSYTHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1428 N STATE HIGHWAY 47, WARRENTON, MO 63383-1375
(660) 676-7526
Mailing address
2204 APPLEROCK DR, O FALLON, MO 63368-3855
(660) 676-7526
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2018040870
MO
Other
Enumeration date
02/18/2019
Last updated
01/08/2021
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