Provider Demographics
NPI:1235274713
Name:O'REILLY, JULIE KATHRYN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:KATHRYN
Last Name:O'REILLY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:KATHRYN
Other - Last Name:O'REILLY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:601 ALSTON PL
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-3516
Mailing Address - Country:US
Mailing Address - Phone:404-488-4720
Mailing Address - Fax:
Practice Address - Street 1:8720 GEORGIA AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3638
Practice Address - Country:US
Practice Address - Phone:404-488-4720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD4308103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist