Individual
GRACE L REILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2144 SUMTER ST, COLUMBIA, SC 29201-2182
(805) 258-0533
Mailing address
611 WACCAMAW AVE APT 11, COLUMBIA, SC 29205-2255
(630) 957-8224
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/31/2024
Last updated
01/31/2024
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