Provider Demographics
NPI:1235838038
Name:CONLEY, MARIA LYNN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:LYNN
Last Name:CONLEY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:LYNN
Other - Last Name:MAAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:1313 MURRAY ST
Mailing Address - Street 2:
Mailing Address - City:FORTY FORT
Mailing Address - State:PA
Mailing Address - Zip Code:18704-4148
Mailing Address - Country:US
Mailing Address - Phone:570-417-4353
Mailing Address - Fax:
Practice Address - Street 1:1313 MURRAY ST
Practice Address - Street 2:
Practice Address - City:FORTY FORT
Practice Address - State:PA
Practice Address - Zip Code:18704-4148
Practice Address - Country:US
Practice Address - Phone:570-417-4353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL013141235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist