Individual
KEVIN JOHN REILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3250 MIDVALE DR APT 701, WILMINGTON, NC 28412-3812
(213) 500-0188
Mailing address
3250 MIDVALE DR APT 701, WILMINGTON, NC 28412-3812
(213) 500-0188
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
114476
CA
Other
Enumeration date
02/14/2012
Last updated
02/05/2024
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