Organization
FRESH START PSYCHOLOGICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIANE GREEN REILLY PHD (MANAGER)
(978) 222-9818
Entity
Organization
Contact information
Practice address
18 RAILROAD ST STE 1, ANDOVER, MA 01810-3570
(978) 222-9818
(978) 824-9475
Mailing address
18 RAILROAD ST STE 1, ANDOVER, MA 01810-3570
(978) 222-9818
(978) 824-9475
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
7734
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1821363615
NPI
MA
Enumeration date
06/18/2017
Last updated
07/21/2022
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