Individual
MARYDORA CONLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT, LCSW
Contact information
Practice address
516 ACADEMY RIDGE PL, LOUISVILLE, KY 40245-3934
(502) 500-1553
Mailing address
516 ACADEMY RIDGE PL, LOUISVILLE, KY 40245-3934
(502) 500-1553
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1966
KY
1041C0700X
Clinical Social Worker
Primary
1966
KY
106H00000X
Marriage & Family Therapist
105233
KY
Other
Enumeration date
06/11/2007
Last updated
02/01/2019
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