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Individual

KEIKO AUREA CASTANEDA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
85 CAMP AVE APT 10B, STAMFORD, CT 06907-1839
(475) 619-1264
Mailing address
85 CAMP AVE APT 10B, STAMFORD, CT 06907-1839
(475) 619-1264

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008089942
CT
Enumeration date
07/08/2019
Last updated
09/11/2022
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