Provider Demographics
NPI:1285848366
Name:CONLY, HANNAH REBEKAH (MS LPC)
Entity Type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:REBEKAH
Last Name:CONLY
Suffix:
Gender:F
Credentials:MS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:705 W LOWRY RD STE 101
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-2107
Mailing Address - Country:US
Mailing Address - Phone:918-697-8548
Mailing Address - Fax:918-341-3779
Practice Address - Street 1:705 W LOWRY RD STE 101
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-2107
Practice Address - Country:US
Practice Address - Phone:918-697-8548
Practice Address - Fax:918-341-3779
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3757101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional