Individual
MRS. BLANCA ESMERALDA REILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. SLP
Contact information
Practice address
500 PECONIC ST APT 288A, RONKONKOMA, NY 11779-7162
(917) 363-7351
Mailing address
500 PECONIC ST APT 288A, RONKONKOMA, NY 11779-7162
(917) 363-7351
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0214761
NY
Other
Enumeration date
12/13/2011
Last updated
01/19/2017
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