Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1164939476 |
---|---|
Provider Name | Raymara Castro |
First Address | Cape Coral, FL 33909-1567 |
Second Address | Cape Coral, FL 33909-1567 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2018 |
Last Update Date | 18/10/2019 |