Individual
MR. GEORGE R HEADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
35 QUEENSWAY LN APT 34, SPRING GROVE, VA 23881-7764
(347) 559-8057
Mailing address
35 QUEENSWAY LN APT 34, SPRING GROVE, VA 23881-7764
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
070453258
—
Other
Enumeration date
06/24/2021
Last updated
06/24/2021
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