Derrick Jack, LSW
NPI #1265096994 in New Albany, Indiana
Provider Information
- NPI Number
- 1265096994
- Entity Type
- Individual
- Name
- Derrick Jack, LSW
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Social Worker
- Credential
- LSW
- Enumeration Date
- Apr 29, 2019
- Last Updated
- Apr 29, 2019
Practice Location
- Address
- 2627 CHARLESTOWN RD
- City
- New Albany
- State
- Indiana
- ZIP Code
- 47150-2536
- Phone
- (812) 944-1550
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker |
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