Individual
SHANNON MICHELLE REILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
24 HOLLIS AVE APT 2R, QUINCY, MA 02171-2361
97888688505
Mailing address
24 HOLLIS AVE APT 2R, QUINCY, MA 02171-2361
97888688505
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/12/2017
Last updated
09/12/2017
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