Individual
MRS. SHANNON METCALF DERRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
1100 E MARKET ST, AFTERCARE PROGRAM, LOUISVILLE, KY 40206-1838
(502) 596-1323
(502) 596-1416
Mailing address
1100 E MARKET ST, AFTERCARE PROGRAM, LOUISVILLE, KY 40206-1838
(502) 596-1323
(502) 596-1416
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0949
KY
Other
Enumeration date
02/03/2012
Last updated
02/03/2012
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