Provider Demographics
NPI:1790058022
Name:CASTELLANO, REYNA
Entity Type:Individual
Prefix:
First Name:REYNA
Middle Name:
Last Name: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 1:1 RIVERFRONT PL STE 750
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72114-5651
Mailing Address - Country:US
Mailing Address - Phone:501-223-8414
Mailing Address - Fax:501-223-8538
Practice Address - Street 1:1 RIVERFRONT PL STE 750
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72114-5651
Practice Address - Country:US
Practice Address - Phone:501-223-8414
Practice Address - Fax:501-223-8538
Is Sole Proprietor?:No
Enumeration Date:2012-02-16
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker