Provider Demographics
NPI:1639707565
Name:CASTILLO, CYNTHIA
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 EL PINON DR
Mailing Address - Street 2:
Mailing Address - City:VINTON
Mailing Address - State:TX
Mailing Address - Zip Code:79821-9342
Mailing Address - Country:US
Mailing Address - Phone:915-790-3121
Mailing Address - Fax:
Practice Address - Street 1:101 EL PINON DR
Practice Address - Street 2:
Practice Address - City:VINTON
Practice Address - State:TX
Practice Address - Zip Code:79821-9342
Practice Address - Country:US
Practice Address - Phone:915-790-3121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-27
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician