Provider Demographics
NPI:1467922369
Name:WINANS, DEREK CURTIS (MA, BCBA, COBA)
Entity Type:Individual
Prefix:MR
First Name:DEREK
Middle Name:CURTIS
Last Name:WINANS
Suffix:
Gender:M
Credentials:MA, BCBA, COBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 W CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-3946
Mailing Address - Country:US
Mailing Address - Phone:419-291-7080
Mailing Address - Fax:419-480-4901
Practice Address - Street 1:2040 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3946
Practice Address - Country:US
Practice Address - Phone:419-291-7080
Practice Address - Fax:419-480-4901
Is Sole Proprietor?:No
Enumeration Date:2018-12-04
Last Update Date:2018-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst