Individual
DR. CHARLES J REILLY
Active
Individual
DR. CHARLES J REILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.D.
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
3037
MA
103TF0200X
Forensic Psychologist
—
—
Other
Enumeration date
03/24/2006
Last updated
05/22/2014
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