Healthcare Provider Details

I. General information

NPI: 1992221485
Provider Name (Legal Business Name): ERIN RITA REILLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2017
Last Update Date: 09/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1113 HEALTHWAY DR
SALISBURY MD
21804-4470
US

IV. Provider business mailing address

13401 JOHN KLINE RD
SMITHSBURG MD
21783-9110
US

V. Phone/Fax

Practice location:
  • Phone: 410-334-6961
  • Fax:
Mailing address:
  • Phone: 301-462-9624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: