Organization
FRESH START PSYCHOLOGICAL SERVICES LLC
Active
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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