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Individual

DR. LESLIE MCCOY CONROY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
86 LAKE ST, BURLINGTON, VT 05401-5297
(802) 865-3450
Mailing address
86 LAKE ST, BURLINGTON, VT 05401-5297
(802) 865-3450

Taxonomy

Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
0420008457
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
OVN 0318
VT
Enumeration date
07/17/2006
Last updated
07/08/2007
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