Derick Allen Eidson

NPI #1811339294 in Ada, Oklahoma

Provider Information

NPI Number: 1811339294
Entity Type: Individual
Name: Derick Allen Eidson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Mental Health
Enumeration Date: Jul 25, 2013
Last Updated: Jul 25, 2013

Practice Location

Address: 19108 COUNTY ROAD 3560
City: Ada
State: Oklahoma
ZIP Code: 74820-0177
Phone: (580) 421-1800

Specialties & Taxonomy Codes

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

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