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General NPI Number Information
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NPI Number | 1407107766
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Entity Type | Individual
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Provider Name | CARRIE B. CONWAY
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Gender | Female
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Dates
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Enumeration Date | 09/27/2012
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Last Update Date | 09/27/2012
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Provider Practice Location Address
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Address Line | 480 DONALD ST
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City | BEDFORD
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State | NH
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Zip | 03110-5945
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Country | US
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Telephone | 603-627-4147
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Fax | 603-644-6906
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Provider Business Mailing Address
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Address Line | 480 DONALD ST
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City | BEDFORD
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State | NH
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Zip | 03110-5945
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Country | US
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Telephone | 603-627-4147
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Fax | 603-644-6906
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 1445
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 6912
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License Number State | MA
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