Individual
JENNIFER REILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2639 W STATE ROAD 434, LONGWOOD, FL 32779-4878
(321) 972-8326
Mailing address
15 ABACUS AVE, ORMOND BEACH, FL 32174-1047
(386) 871-0428
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 12985
FL
Other
Enumeration date
06/27/2014
Last updated
03/28/2022
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