Doctor Name: | LYNNE F REILLY |
NPI Number: | 1962534321 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MFT LADC |
License Number: | 1088 |
Business Practice Address: | 865 Tahoe Blvd # 107 Incline Village, NV - 894519452 |
Business Phone Number: | 7758331622 |
Business Fax Number: | 7758331719 |
Mailing Address: | Po Box 5267, 865 Tahoe Blvd. Suite 107 INCLINE VILLAGE |
State: | NV |
Postal Code: | 894505267 |
Phone Number: | 7758331622 |
Fax Number: | 7758331718 |
NPI Enumeration Date: | 03/12/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 1088 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | NV |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |