Individual
KEITH J REILLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
101 W READ ST UNIT B03, BALTIMORE, MD 21201-4906
(610) 733-0304
Mailing address
101 W READ ST UNIT B03, BALTIMORE, MD 21201-4906
(610) 733-0304
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
R210605
MD
Other
Enumeration date
11/13/2019
Last updated
11/13/2019
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