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Individual

DR. CHARLES J REILLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ED.D.

Contact information

Practice address
158 UPLAND RD, WABAN, MA 02468-2005
(617) 527-5561
Mailing address
158 UPLAND RD, WABAN, MA 02468-2005
(617) 527-5561

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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