Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003454299 |
---|---|
Provider Name | Martha Castillo |
First Address | Sherman Oaks, CA 91403-1172 |
Second Address | Sherman Oaks, CA 91403-1172 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2019 |
Last Update Date | 18/12/2019 |