Individual
MS. MARY T CONWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
47 TOWN ST, NORWICH, CT 06360-2315
(860) 892-7042
(860) 823-3060
Mailing address
47 TOWN ST, NORWICH, CT 06360-2315
(860) 892-7042
(860) 823-3060
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
6401008004
MI
101YP2500X
Professional Counselor
Primary
001624
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004264066
—
CT
Enumeration date
03/19/2007
Last updated
08/05/2011
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