Provider Demographics
NPI:1194735548
Name:CONRAD, BARBARA PHYLLIS (MS)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:PHYLLIS
Last Name:CONRAD
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 CONCORD PIKE
Mailing Address - Street 2:SUITE 92-100
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-3612
Mailing Address - Country:US
Mailing Address - Phone:610-368-0324
Mailing Address - Fax:302-655-4027
Practice Address - Street 1:1601 CONCORD PIKE
Practice Address - Street 2:SUITE 92-100
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3612
Practice Address - Country:US
Practice Address - Phone:610-368-0324
Practice Address - Fax:302-655-4027
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000268101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health