Provider Demographics
NPI:1700211380
Name:CONLEY, RENEE MICHELLE (MA LLPC)
Entity Type:Individual
Prefix:MISS
First Name:RENEE
Middle Name:MICHELLE
Last Name:CONLEY
Suffix:
Gender:F
Credentials:MA LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 S MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-4426
Mailing Address - Country:US
Mailing Address - Phone:734-883-8896
Mailing Address - Fax:
Practice Address - Street 1:804 S MAPLE RD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-4426
Practice Address - Country:US
Practice Address - Phone:734-883-8896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-13
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401013707101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor