Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 103TR0400X | FL |
N | 103TR0400X | Rehabilitation Psychologist | 103TR0400X | FL |
NPI | 1407221831 |
---|---|
Provider Name | Jennifer Castro |
First Address | Orlando, FL 32822-2421 |
Second Address | Orlando, FL 32822 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2015 |
Last Update Date | 14/04/2021 |