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General NPI Number Information
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NPI Number | 1083765119
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Entity Type | Individual
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Provider Name | BREE R. CONRAD M.A.
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Gender | Female
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 06/25/2010
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Provider Practice Location Address
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Address Line | 400 E 6TH ST
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City | PARKVILLE
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State | MO
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Zip | 64152-3703
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Country | US
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Telephone | 816-452-8910
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Fax | 816-452-0245
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Provider Business Mailing Address
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Address Line | 598 N WINNEBAGO DR
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City | LAKE WINNEBAGO
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State | MO
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Zip | 64034-9400
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Country | US
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Telephone | 816-286-5098
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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