Derrick Medearis

NPI #1063677052 in Berlin, New Jersey

Provider Information

NPI Number: 1063677052
Entity Type: Individual
Name: Derrick Medearis
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Mental Health
Enumeration Date: Jul 19, 2008
Last Updated: Jul 19, 2008

Practice Location

Address: 128 CROSS KEYS RD
City: Berlin
State: New Jersey
ZIP Code: 08009-9201
Phone: (856) 210-1511

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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