Provider Demographics
NPI:1437375193
Name:CONROY, MARY RYAN (MAC, LAC DIPL)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:RYAN
Last Name:CONROY
Suffix:
Gender:F
Credentials:MAC, LAC DIPL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3419 MCKINLEY ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-2511
Mailing Address - Country:US
Mailing Address - Phone:202-244-7826
Mailing Address - Fax:
Practice Address - Street 1:8505 FENTON ST
Practice Address - Street 2:SUITE 202
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4497
Practice Address - Country:US
Practice Address - Phone:301-565-4924
Practice Address - Fax:301-565-4927
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01502171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist