Basic Information
| Provider Information | |||||||||
| NPI: | 1750518833 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CONROY | ||||||||
| FirstName: | DIANNE | ||||||||
| MiddleName: | LEE | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7321 ANGEL FIRE DR | ||||||||
| Address2: | |||||||||
| City: | PLANO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750252620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2147251958 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2003 SE WALTON BLVD | ||||||||
| Address2: | |||||||||
| City: | BENTONVILLE | ||||||||
| State: | AR | ||||||||
| PostalCode: | 727123725 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4797256000 | ||||||||
| FaxNumber: | 4797504843 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2009 | ||||||||
| LastUpdateDate: | 03/21/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | P1901014 | AR | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.