Provider Demographics
NPI:1063459923
Name:CONROY, CAROLYN G (PHD)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:G
Last Name:CONROY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1012
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28793-1012
Mailing Address - Country:US
Mailing Address - Phone:828-698-1779
Mailing Address - Fax:
Practice Address - Street 1:840 FLEMING ST
Practice Address - Street 2:SUITE 5
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-3513
Practice Address - Country:US
Practice Address - Phone:828-698-1779
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2188174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0143XOtherBC/BS
NC0143XOtherBC/BS