Provider Demographics
NPI:1831321892
Name:REILLY, DEBORAH S (MS)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:S
Last Name:REILLY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 GLENIFFER HILL RD
Mailing Address - Street 2:
Mailing Address - City:RICHBORO
Mailing Address - State:PA
Mailing Address - Zip Code:18954-1368
Mailing Address - Country:US
Mailing Address - Phone:215-354-1253
Mailing Address - Fax:
Practice Address - Street 1:206 CORPORATE DR.
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-8007
Practice Address - Country:US
Practice Address - Phone:267-799-3079
Practice Address - Fax:215-579-6165
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-10
Last Update Date:2014-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006504101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional