Provider Demographics
NPI:1760189971
Name:VILLALOBOS CASTELLANO, PAOLA ANDREA
Entity Type:Individual
Prefix:
First Name:PAOLA
Middle Name:ANDREA
Last Name:VILLALOBOS CASTELLANO
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 1:6839 SEA CORAL DR APT 100
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32821-8063
Mailing Address - Country:US
Mailing Address - Phone:561-814-0109
Mailing Address - Fax:
Practice Address - Street 1:6839 SEA CORAL DR APT 100
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32821-8063
Practice Address - Country:US
Practice Address - Phone:561-814-0109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-08
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst