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General NPI Number Information
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NPI Number | 1972601375
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Entity Type | Individual
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Provider Name | MARIANNE G CONWAY M.A.
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Gender | Female
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | BAYVIEW ASSOCIATES/SOUTH SHORE MENTAL HEALTH 310 BARNSTABLE ROAD
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City | HYANNIS
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State | MA
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Zip | 02601
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Country | US
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Telephone | 508-862-0514
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Fax | 508-862-9184
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Provider Business Mailing Address
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Address Line | 6 CHRISTINA LANE
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City | SANDWICH
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State | MA
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Zip | 02563
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Country | US
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Telephone | 508-420-6883
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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 | 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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