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NPI Code Detail

MEDICARE: MS. BREE R. CONRAD M.A.

MEDICARE: MS. BREE R. CONRAD M.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor
2106H00000XMarriage & Family Therapist
3101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1083765119
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BREE R. CONRAD M.A.
Provider Business Mailing Address
First Line : 598 N WINNEBAGO DR
Second Line :
City : LAKE WINNEBAGO
State : MO
Zip : 64034-9400
Country : US
Telephone Number : 816-286-5098
Fax Number :
Provider Business Practice Location Address
First Line : 400 E 6TH ST
Second Line :
City : PARKVILLE
State : MO
Zip : 64152-3703
Country : US
Telephone Number : 816-452-8910
Fax Number : 816-452-0245
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2007
Last Update Date : 06/25/2010

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Directions to “ MS. BREE R. CONRAD M.A.” Practice Location

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