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General NPI Number Information
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NPI Number | 1609222850
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Entity Type | Individual
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Provider Name | KATHRYN AURORA HEADLEY CPPM,QPIN
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Gender | Female
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Dates
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Enumeration Date | 05/06/2016
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Last Update Date | 12/27/2024
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Provider Practice Location Address
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Address Line | 11011 SHERIDAN ST STE 210
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City | HOLLYWOOD
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State | FL
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Zip | 33026-1531
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Country | US
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Telephone | 954-552-6668
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Fax |
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Provider Business Mailing Address
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Address Line | 270 SW 112TH TER
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City | PEMBROKE PINES
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State | FL
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Zip | 33025-3410
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Country | US
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Telephone | 954-449-3740
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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