Individual
MRS. GRETCHEL DE LOS MILAGROS CASTANEDA VAZQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CBHCM
Contact information
Practice address
3013 NW DOUGLAS CIR, CAPE CORAL, FL 33993-8657
(786) 236-8012
Mailing address
3013 NW DOUGLAS CIR, CAPE CORAL, FL 33993-8657
(786) 236-0812
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
CBHCM103939
FL
171M00000X
Case Manager/Care Coordinator
Primary
CBHCM103939
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122859100
—
FL
Enumeration date
07/27/2021
Last updated
09/12/2024
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