Individual
RUTH IMELDA CASTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 ANDREA DR, SIERRA VISTA, AZ 85635-2005
(520) 459-8965
Mailing address
1401 ANDREA DR, SIERRA VISTA, AZ 85635-2005
(520) 459-8965
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000000
—
AZ
Enumeration date
11/17/2008
Last updated
07/21/2022
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