Individual provider · Type 1 NPI

Shannon Derico

Mental Health Counselor · Gary, IN

NPI number 1548675739 Active

Practice location

1100 W 6th Ave
Gary, IN 46402-1711

Fax (219) 888-9408

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1548675739

Shannon Derico's National Provider Identifier is 1548675739, issued on Jun 25, 2014. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Gary, IN. The record was last updated on Jun 25, 2014.