Doctor Name: | MS. THERESA MARIE REILLY |
NPI Number: | 1154558435 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. CCC-SLP |
License Number: | 015741 |
Business Practice Address: | 8460 Parsons Blvd Jamaica, NY - 114322544 |
Business Phone Number: | 7182986161 |
Business Fax Number: | |
Mailing Address: | 22 Elbow Ln, LEVITTOWN |
State: | NY |
Postal Code: | 117565502 |
Phone Number: | 5265130757 |
Fax Number: | |
NPI Enumeration Date: | 06/15/2009 |
NPI Last Update Date: | 06/15/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 015741 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |