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Individual

MR. RICHARD DEAN REILLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCPC

Contact information

Practice address
10400 RIDGLAND RD, STE 1, COCKEYSVILLE, MD 21030-2715
(410) 628-6120
(410) 628-0953
Mailing address
10400 RIDGLAND RD, STE 1, COCKEYSVILLE, MD 21030-2715
(410) 628-6120
(410) 628-9825

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC2216
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
410893100
MD
Enumeration date
11/01/2006
Last updated
12/04/2012
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