Individual
DR. KATHELEEN REIDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH D
Contact information
Practice address
1315 WALNUT ST, SUITE 1700, PHILADELPHIA, PA 19107-4719
(215) 717-2716
(215) 545-8496
Mailing address
1630 RIVERSIDE DRIVE, TRENTON, NJ 08618-5837
(609) 947-1116
(215) 545-8496
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
35SI00404500
NJ
103T00000X
Psychologist
Primary
PS005184L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0767179000
AMERIHEALTH
NJ
01
—
0767179000
AMERIHEALTH
PA
01
—
285008
MHN
—
01
—
350265000
MAGELLAN BEHAVIORAL HEALT
—
01
—
7093421
AETNA
—
Enumeration date
07/14/2006
Last updated
07/08/2007
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