Provider Demographics
NPI:1386424901
Name:WILLER, DARBY CAREEN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:DARBY
Middle Name:CAREEN
Last Name:WILLER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5560 NW 25TH LOOP
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34482-4263
Mailing Address - Country:US
Mailing Address - Phone:323-828-5557
Mailing Address - Fax:
Practice Address - Street 1:5560 NW 25TH LOOP
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34482-4263
Practice Address - Country:US
Practice Address - Phone:323-828-5557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10868235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist