Healthcare Provider Details

I. General information

NPI: 1871427336
Provider Name (Legal Business Name): MELISSA REILLY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 WEST AVE
SPRINGFIELD PA
19064-3625
US

IV. Provider business mailing address

140 WEST AVE
SPRINGFIELD PA
19064-3625
US

V. Phone/Fax

Practice location:
  • Phone: 610-322-0022
  • Fax:
Mailing address:
  • Phone: 610-322-0022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBH001170
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: