MR. DERRYCK MOORE, LADC

Counselor - Addiction (Substance Use Disorder)

Active Individual
NPI: 1336381599

Practice Address

12400 25TH AVE N
Plymouth, MN 55441

Phone: (612) 220-8645

Specialties

Specialty Code Primary License
Counselor - Addiction (Substance Use Disorder) 101YA0400X Yes 301674 (MN)

Frequently Asked Questions

NPI 1336381599 is the National Provider Identifier for MR. DERRYCK MOORE, LADC, a Counselor - Addiction (Substance Use Disorder) provider located in Plymouth, MN. This NPI was enumerated on April 1, 2009.
MR. DERRYCK MOORE, LADC practices at 12400 25TH AVE N, Plymouth, MN 55441.

Quick Facts

NPI
1336381599
Type
Individual
Enumerated
Apr 1, 2009
Last Updated
Apr 1, 2009

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