Individual
DERRICK RAYNARD DAVIS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S. SLP
Contact information
Practice address
5165 ADANSON ST, ORLANDO, FL 32804-1331
(352) 394-0212
Mailing address
PO BOX 120547, CLERMONT, FL 34712-0547
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SZ11426
FL
Other
Enumeration date
12/18/2023
Last updated
12/18/2023
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