Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | SW128684 | PA |
Y | 1041C0700X | Clinical Social Worker | CW019584 | PA |
NPI | 1003192212 |
---|---|
Provider Name | Nancy J Conway |
First Address | Malvern, PA 19355-1530 |
Second Address | Malvern, PA 19355-1530 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2011 |
Last Update Date | 17/03/2018 |