Individual
KIMBERLY ROSE REILY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
289 STANLEY RD, WINTHROP, ME 04364-3336
(207) 931-6319
Mailing address
289 STANLEY RD, WINTHROP, ME 04364-3336
(207) 931-6319
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
06331
MD
235Z00000X
Speech-Language Pathologist
Primary
SP1675
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
098471
ANTHEM
ME
05
—
432325699
—
ME
Enumeration date
11/20/2006
Last updated
04/12/2024
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