Individual
RAY D CONLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW , LCAC
Contact information
Practice address
909 E STATE BLVD, FORT WAYNE, IN 46805-3404
(260) 481-2700
(260) 481-2838
Mailing address
909 E STATE BLVD, FORT WAYNE, IN 46805-3404
(260) 481-2700
(260) 481-2838
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
87000955A
IN
104100000X
Social Worker
Primary
33000992A
IN
Other
Enumeration date
11/21/2011
Last updated
02/06/2013
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