Individual
JENNIFER REBECCA CONLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
225 CARLTON DAVIDSON LN, COAL GROVE, OH 45638-2924
(740) 354-7702
(740) 353-1662
Mailing address
225 CARLTON DAVIDSON LN, COAL GROVE, OH 45638-2924
(740) 354-7702
(740) 353-1662
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
3677
KY
1041C0700X
Clinical Social Worker
DP00944265
WV
1041C0700X
Clinical Social Worker
Primary
I.1302248
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005355002
—
WV
05
—
30610026
—
KY
Enumeration date
11/27/2012
Last updated
10/05/2015
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