Moore, Derrick Michael

Moore, Derrick Michael is an sole proprietor health care provider with primary practice located at 1500 E. Woodrow Wilson Dr. , Jackson MS 39216-5199. He recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as his primary health care specialty. Moore, Derrick Michael can be contacted via phone (601) 362-4471.

Contact Information

Primary practice address
1500 E. Woodrow Wilson Dr. Jackson MS 39216-5199
Phone: (601) 362-4471
Fax: (601) 368-4093
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X M6782 Mississippi

Profile Details

NPI number 1902950736
LBN Legal business name Moore, Derrick Michael
Credentials LMSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 22nd, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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