Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | LC3686 | MD |
NPI | 1003217001 |
---|---|
Provider Name | Nadine Castro |
First Address | Timonium, MD 21093-4128 |
Second Address | Baltimore, MD 21218-5778 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2014 |
Last Update Date | 09/09/2014 |