Individual
MS. PENELOPE REILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN CS
Contact information
Practice address
222 ST JOHN STREET SUITE 102, PORTLAND, ME 04102
(207) 874-0341
Mailing address
12 HARVEY ST, PORTLAND, ME 04102-1736
(207) 874-0341
Taxonomy
Speciality
Code
Description
License number
State
364SP0807X
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
Primary
R025391
ME
Other
Enumeration date
02/20/2007
Last updated
07/08/2007
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