Search › Georgia › 101YM0800X
Ebony Derrickson, MS DDP
NPI 1881336907 · on the registry since 2022 · sole proprietor
Practice
- Address
- 125 Lee Byrd Rd
Loganville, GA 30052 - Phone
- (678) 883-8609
- Organisation at this address
- Awino Speaks Llc
Creative Minds For Wellness, LlcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 4
Additional practice sites
- 2795 Main St W, Snellville, GA
Registry record
- Primary taxonomy
- 101YM0800X
101YM0800X
- Also registered as
- 101Y00000X
103TC1900X - Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2022-04-09
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia