Provider Demographics
NPI:1639491467
Name:REILLY, ERICA THERESE (CD(DONA))
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:THERESE
Last Name:REILLY
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 CUSHMAN LNDG
Mailing Address - Street 2:
Mailing Address - City:PLYMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:02367-1726
Mailing Address - Country:US
Mailing Address - Phone:781-582-9901
Mailing Address - Fax:
Practice Address - Street 1:14 CUSHMAN LNDG
Practice Address - Street 2:
Practice Address - City:PLYMPTON
Practice Address - State:MA
Practice Address - Zip Code:02367-1726
Practice Address - Country:US
Practice Address - Phone:781-582-9901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-21
Last Update Date:2010-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula