Individual
MR. DERRICK TYRONE GILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CHW, NDPP-LCC-CDC-MI
Contact information
Practice address
249 OAKRIDGE DR, MARQUETTE, MI 49855-8864
(248) 573-9465
Mailing address
249 OAKRIDGE DR, MARQUETTE, MI 49855-8864
(248) 573-9465
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
MI
101YP1600X
Pastoral Counselor
—
MI
171400000X
Health & Wellness Coach
Primary
—
MI
172A00000X
Driver
—
MI
Other
Enumeration date
06/02/2025
Last updated
06/02/2025
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