Individual
BRIAN P REILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., CCC-SLP
Contact information
Practice address
2635 TUSCARORA CT, W MELBOURNE, FL 32904-8092
(321) 536-1779
Mailing address
2635 TUSCARORA CT, W MELBOURNE, FL 32904-8092
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA 8591
FL
Other
Enumeration date
02/27/2013
Last updated
02/27/2013
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