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Individual

MS. ELAINE THERESE CONWAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, LPC

Contact information

Practice address
934 S CLAY ST, GREEN BAY, WI 54301-3419
(920) 819-6570
Mailing address
3900 W BROWN DEER RD, SUITE 200, BROWN DEER, WI 53209-1220
(414) 540-2170
(414) 540-2171

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3537-125
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40953300
WI
Enumeration date
08/24/2007
Last updated
09/18/2008
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