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Individual

MS. JESSICA ELLEN CONWAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, MFT

Contact information

Practice address
1409 GRANDIN RD SW, ROANOKE, VA 24015-2317
(703) 899-2983
Mailing address
2713 LANSING DR SW, ROANOKE, VA 24015-3928
(703) 899-2983

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0171001384
VA
106H00000X
Marriage & Family Therapist
0717001384
VA
106H00000X
Marriage & Family Therapist
46463
CA

Other

Enumeration date
02/20/2007
Last updated
03/16/2023
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