Individual
KEVIN T REILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A., L.L.P.
Contact information
Practice address
23400 MICHIGAN AVE, SUITE 702, DEARBORN, MI 48124-1924
(313) 274-1656
(313) 274-3010
Mailing address
44242 ARLINGTON RD, CANTON, MI 48187-2144
(313) 274-1656
(313) 274-3010
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301006428
MI
Other
Enumeration date
08/09/2006
Last updated
07/08/2007
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