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Individual

MRS. EVELYN FAYE CONLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
112 E CHART ST, PLAINWELL, MI 49080-1768
(269) 685-6363
(269) 685-5995
Mailing address
2309 JAMES ST, KALAMAZOO, MI 49001-4370
(269) 806-6315
(269) 388-4439

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1518448
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
59-3795383
MI
Enumeration date
10/12/2009
Last updated
10/12/2009
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