Provider Demographics
NPI:1760119770
Name:CASTILLO, LITTLE FEATHER JOCELYN (COTA)
Entity Type:Individual
Prefix:
First Name:LITTLE FEATHER
Middle Name:JOCELYN
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 POWELL CIR
Mailing Address - Street 2:
Mailing Address - City:FIVE POINTS
Mailing Address - State:TN
Mailing Address - Zip Code:38457-9749
Mailing Address - Country:US
Mailing Address - Phone:419-980-3969
Mailing Address - Fax:
Practice Address - Street 1:7108 SOUTH KANNER HWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34996-8801
Practice Address - Country:US
Practice Address - Phone:855-832-6727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-01
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant