MEDICARE: CYNTHIA CONNER LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	50135	TX

General Provider Information

NPI Number	:	1194969360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA CONNER LCSW

Provider Business Mailing Address
First Line	:	2 GREENWAY PLZ
Second Line	:	SUITE 900
City	:	HOUSTON
State	:	TX
Zip	:	77046-0297
Country	:	US
Telephone Number	:	713-495-3722
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 GREENWAY PLZ
Second Line	:	SUITE 900
City	:	HOUSTON
State	:	TX
Zip	:	77046-0297
Country	:	US
Telephone Number	:	713-495-3722
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/30/2009
Last Update Date	:	01/12/2011

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