Individual
MIRANDA LEIGH CASTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN, CDE
Contact information
Practice address
16111 IKE LN, SELMA, TX 78154-1154
(361) 813-8810
Mailing address
16111 IKE LN, SELMA, TX 78154-1154
(361) 813-8810
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DT84930
TX
Other
Enumeration date
01/18/2018
Last updated
03/25/2020
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