Provider Demographics
NPI:1063734945
Name:CONLEY, NANCY JANE (MSCCCSLP)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:JANE
Last Name:CONLEY
Suffix:
Gender:F
Credentials:MSCCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10730 PASO FINO DR
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33449-8033
Mailing Address - Country:US
Mailing Address - Phone:561-290-8511
Mailing Address - Fax:
Practice Address - Street 1:10730 PASO FINO DR
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33449-8033
Practice Address - Country:US
Practice Address - Phone:561-290-8511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-19
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA5759235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist