Individual
MR. DEREK ROBERT RACICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSSA, MA, LISW-S
Contact information
Practice address
3200 VINE ST., CINCINNATI VA MEDICAL CENTER, CINCINNATI, OH 45220
(513) 861-3100
Mailing address
6382 BIRCHDALE CT, CINCINNATI, OH 45230-3635
(216) 702-6994
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I.1500815-SUPV
OH
Other
Enumeration date
07/18/2018
Last updated
07/18/2018
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