Healthcare Provider Details

I. General information

NPI: 1669853925
Provider Name (Legal Business Name): CHRISTINE GODSHALL CONWAY PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2015
Last Update Date: 06/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 HARRISBURG AVE FRANKLIN & MARSHALL COLLEGE - APPEL HEALTH SCIENCES
LANCASTER PA
17603-2827
US

IV. Provider business mailing address

415 HARRISBURG AVE FRANKLIN & MARSHALL COLLEGE - APPEL HEALTH SCIENCES
LANCASTER PA
17603-2827
US

V. Phone/Fax

Practice location:
  • Phone: 717-291-4082
  • Fax: 717-291-4277
Mailing address:
  • Phone: 717-291-4082
  • Fax: 717-291-4277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPS006711L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: