Individual
DR. DIANE THERESA CASTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1501 SAN PEDRO DR SE, ALBUQUERQUE, NM 87108-5153
(505) 265-1711
(505) 256-6413
Mailing address
8020 CAMINO DE AGUILA NW, ALBUQUERQUE, NM 87120-5902
(505) 836-5752
(505) 256-6413
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0767
NM
Other
Enumeration date
08/16/2006
Last updated
07/08/2007
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