Provider Demographics
NPI:1508095498
Name:CONRAD, CHRISTIANNA MAE (MA, DTR)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTIANNA
Middle Name:MAE
Last Name:CONRAD
Suffix:
Gender:F
Credentials:MA, DTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 QUEEN ST
Mailing Address - Street 2:
Mailing Address - City:DOUGLASSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19512
Mailing Address - Country:US
Mailing Address - Phone:484-614-9785
Mailing Address - Fax:
Practice Address - Street 1:1 MENNONITE CHURCH RD
Practice Address - Street 2:
Practice Address - City:SPRING CITY
Practice Address - State:PA
Practice Address - Zip Code:19475-1518
Practice Address - Country:US
Practice Address - Phone:610-948-6490
Practice Address - Fax:610-474-0011
Is Sole Proprietor?:No
Enumeration Date:2009-07-13
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor