Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 1587 | PR |
NPI | 1114145943 |
---|---|
Provider Name | Mrs. Aiddie B Castro |
First Address | Boqueron, PR 00622 |
Second Address | Mayaguez, PR 00682-1500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2007 |
Last Update Date | 08/07/2007 |