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General NPI Number Information
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NPI Number | 1033603410
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Entity Type | Individual
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Provider Name | ANNA MARIAH CONAWAY CADC
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Gender | Female
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Dates
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Enumeration Date | 06/19/2018
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Last Update Date | 06/19/2018
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Provider Practice Location Address
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Address Line | 801 N WEST ST
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City | WILMINGTON
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State | DE
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Zip | 19801-1525
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Country | US
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Telephone | 302-656-8326
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Fax |
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Provider Business Mailing Address
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Address Line | 193 BRANDYWINE BLVD
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City | WILMINGTON
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State | DE
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Zip | 19809-3237
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Country | US
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Telephone | 302-540-1097
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1811
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License Number State | DE
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