Individual
EDGAR CONWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRAADC/SQP
Contact information
Practice address
4218 N GRAND BLVD, SAINT LOUIS, MO 63107-1806
(314) 534-6624
Mailing address
4218 N GRAND BLVD, SAINT LOUIS, MO 63107-1806
(314) 534-6624
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
923
MO
Other
Enumeration date
09/14/2023
Last updated
09/14/2023
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