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Individual

BETHANY JORDAN CASTILLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMHC, NCC

Contact information

Practice address
973 CAMINO HERMOSA, CORRALES, NM 87048-8436
(505) 803-7459
Mailing address
2216 VIOLETA CIR SE, RIO RANCHO, NM 87124-2585
(505) 908-1237

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
1165835
101YM0800X
Mental Health Counselor
Primary
CMH0203301
NM

Other

Enumeration date
04/10/2019
Last updated
04/10/2019
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