Doctor Name: | MS. JULIE MILES REILLY |
NPI Number: | 1154510733 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CWII |
License Number: | |
Business Practice Address: | 225 Cabrillo Hwy S Ste 200a Half Moon Bay, CA - 940197210 |
Business Phone Number: | 6505733755 |
Business Fax Number: | 6507264963 |
Mailing Address: | 225 Cabrillo Hwy S Ste 200a, HALF MOON BAY |
State: | CA |
Postal Code: | 940197210 |
Phone Number: | 6505733755 |
Fax Number: | 6507264963 |
NPI Enumeration Date: | 10/18/2007 |
NPI Last Update Date: | 10/18/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |