Individual
TABATHA REILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
401 S MAIN ST, CAVE CITY, AR 72521-9507
(870) 283-1034
Mailing address
43 TIMBERLANE DR, HIGHLAND, AR 72542-9146
(870) 847-4649
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
02/10/2012
Last updated
02/10/2012
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