Individual
MR. WILLIE CONLEY IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5707 N 22ND ST, TAMPA, FL 33610-4350
(813) 239-8069
Mailing address
5611 E 29TH AVE, TAMPA, FL 33619-1513
(813) 595-0393
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/07/2024
Last updated
07/03/2025
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