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NPI Code Detail

MEDICARE: ALEXANDRA REILLY

MEDICARE: ALEXANDRA REILLY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician
2103K00000XBehavior AnalystBACB563752NC

General Provider Information

NPI Number : 1558901876
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRA REILLY
Provider Business Mailing Address
First Line : 2102 CAMBRIDGE BELTWAY DR STE E
Second Line :
City : CHARLOTTE
State : NC
Zip : 28273-4354
Country : US
Telephone Number : 704-799-6824
Fax Number : 704-799-6825
Provider Business Practice Location Address
First Line : 2102 CAMBRIDGE BELTWAY DR STE E
Second Line :
City : CHARLOTTE
State : NC
Zip : 28273-4354
Country : US
Telephone Number : 704-799-6824
Fax Number : 704-799-6825
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/15/2020
Last Update Date : 01/04/2024

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Directions to “ ALEXANDRA REILLY ” Practice Location

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