Provider Demographics
NPI:1346574555
Name:CONREY, DANIELLE MARIE (MED)
Entity Type:Individual
Prefix:MISS
First Name:DANIELLE
Middle Name:MARIE
Last Name:CONREY
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3165 MCKELVEY RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BRIDGETON
Mailing Address - State:MO
Mailing Address - Zip Code:63044-2550
Mailing Address - Country:US
Mailing Address - Phone:314-206-3436
Mailing Address - Fax:314-206-3992
Practice Address - Street 1:3165 MCKELVEY RD
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044-2550
Practice Address - Country:US
Practice Address - Phone:314-206-3436
Practice Address - Fax:314-206-3992
Is Sole Proprietor?:No
Enumeration Date:2009-09-22
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health