Individual
MRS. ANDREA H CONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPA
Contact information
Practice address
1612 DOCTORS CIR, WILMINGTON, NC 28401-7406
(910) 762-1190
(910) 762-1195
Mailing address
10249 TIMBER RIDGE CT SE, LELAND, NC 28451-8536
(910) 599-4857
(910) 762-1195
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2328
NC
103TB0200X
Cognitive & Behavioral Psychologist
2328
NC
103TC0700X
Clinical Psychologist
Primary
2328
NC
103TC2200X
Clinical Child & Adolescent Psychologist
2328
NC
103TF0000X
Family Psychologist
2328
NC
103TP2701X
Group Psychotherapy Psychologist
2328
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6107336
—
NC
Enumeration date
11/01/2006
Last updated
09/24/2013
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