Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 110696 | TX |
NPI | 1003328352 |
---|---|
Provider Name | Mrs. Dailen C. Castillo |
First Address | San Antonio, TX 78251-5026 |
Second Address | San Antonio, TX 78251-5026 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2017 |
Last Update Date | 26/10/2017 |