Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 4044 | OH |
Y | 103TC0700X | Clinical Psychologist | 4044 | OH |
NPI | 1003145368 |
---|---|
Provider Name | Diane Patricia Castelli |
First Address | Cincinnati, OH 45237-2621 |
Second Address | Cincinnati, OH 45237-2621 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2009 |
Last Update Date | 31/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CP07316 | MEDICARE PTAN (01) | OH |