Provider Demographics
NPI:1952099426
Name:REILLY, ALIANORA (MT-BC)
Entity Type:Individual
Prefix:
First Name:ALIANORA
Middle Name:
Last Name:REILLY
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 WALLINGFORD RD
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-4746
Mailing Address - Country:US
Mailing Address - Phone:860-729-1309
Mailing Address - Fax:
Practice Address - Street 1:57 WALLINGFORD RD
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135-4746
Practice Address - Country:US
Practice Address - Phone:860-729-1309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA17802225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist