Individual
KATHLEEN REILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
194 WATERMAN ST, PROVIDENCE, RI 02906-4015
(401) 633-2929
(888) 602-6957
Mailing address
194 WATERMAN ST, PROVIDENCE, RI 02906-4015
(401) 633-2929
(888) 602-6957
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN03630
RI
Other
Enumeration date
03/20/2023
Last updated
12/27/2023
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