Provider Demographics
NPI:1164281804
Name:CASTILLO ROBLES, MIRIAM (BCBA)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:
Last Name:CASTILLO ROBLES
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7638 UMATILLA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80221-4219
Mailing Address - Country:US
Mailing Address - Phone:720-238-5213
Mailing Address - Fax:
Practice Address - Street 1:14950 W 64TH AVE STE C
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80007-8291
Practice Address - Country:US
Practice Address - Phone:720-642-7019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-24-70884103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst