Provider Demographics
NPI:1689025165
Name:STIKELEATHER, MARIBEL CASTILLO (BCBA)
Entity Type:Individual
Prefix:
First Name:MARIBEL
Middle Name:CASTILLO
Last Name:STIKELEATHER
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 1:1343 MAIN ST STE 705
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-5630
Mailing Address - Country:US
Mailing Address - Phone:650-540-1121
Mailing Address - Fax:
Practice Address - Street 1:1343 MAIN ST STE 705
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-5630
Practice Address - Country:US
Practice Address - Phone:650-540-1121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-27
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-16-22089103K00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst