Provider Demographics
NPI:1295327856
Name:CONROY, TAYLA CORYNE
Entity type:Individual
Prefix:
First Name:TAYLA
Middle Name:CORYNE
Last Name:CONROY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 CONGRESS ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-4130
Mailing Address - Country:US
Mailing Address - Phone:508-422-0242
Mailing Address - Fax:
Practice Address - Street 1:12 CONGRESS ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-4130
Practice Address - Country:US
Practice Address - Phone:508-422-0242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-05
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker