Individual
DEREK HEADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS CCC-SLP
Contact information
Practice address
2704 NE 8TH AVE, WILTON MANORS, FL 33334
(954) 218-2184
Mailing address
2704 NE 8TH AVE, WILTON MANORS, FL 33334-2654
(954) 218-2184
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
10739
NC
235Z00000X
Speech-Language Pathologist
1789
WV
235Z00000X
Speech-Language Pathologist
Primary
2910
ID
Other
Enumeration date
05/24/2009
Last updated
08/01/2018
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