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General NPI Number Information
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NPI Number | 1225828049
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Entity Type | Individual
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Provider Name | AUDRIE MARIE REILLY PSYD
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Gender | Female
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Dates
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Enumeration Date | 05/07/2025
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 3067 E WARM SPRINGS RD STE 100
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City | LAS VEGAS
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State | NV
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Zip | 89120-3750
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Country | US
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Telephone | 702-202-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 9233 E NEVILLE AVE UNIT 1086
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City | MESA
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State | AZ
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Zip | 85209-1509
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Country | US
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Telephone | 480-930-6728
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PA163
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License Number State | NV
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