Individual
DR. WILLIAM DERRY HEASLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
85 EASTERN AVE, SUITE 108, GLOUCESTER, MA 01930-1869
(978) 282-8281
(978) 282-1143
Mailing address
85 EASTERN AVE, SUITE 108, GLOUCESTER, MA 01930-1869
(978) 282-8281
(978) 282-1143
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
7033
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W05600
CLINICAL PSYCHOLOGIST
MA
Enumeration date
12/21/2006
Last updated
06/20/2013
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