Individual
DERRICK KIRK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3600 JACKSON ST STE 111B, ALEXANDRIA, LA 71303-3000
(318) 483-4155
Mailing address
3600 JACKSON ST STE 11B, ALEXANDRIA, LA 71303-3040
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/30/2020
Last updated
09/30/2020
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