Provider Demographics
NPI:1346850047
Name:CASTILLO, NOEMI (COUNSELOR)
Entity Type:Individual
Prefix:MRS
First Name:NOEMI
Middle Name:
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1621 E VINE ST
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-3730
Mailing Address - Country:US
Mailing Address - Phone:407-718-2131
Mailing Address - Fax:
Practice Address - Street 1:1621 E VINE ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-3730
Practice Address - Country:US
Practice Address - Phone:407-718-2131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-06
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent