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Individual

MS. DEBRA LYNN CONWAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS LPC

Contact information

Practice address
108 N LINCOLN AVE, BEAVER DAM, WI 53916
(920) 887-8751
(920) 887-3977
Mailing address
129 BURCHARD STREET, BEAVER DAM, WI 53916
(920) 356-1536

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3157125
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40932800
WI
Enumeration date
11/02/2006
Last updated
07/08/2007
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