Individual
WANDA CASILLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 N MAIN ST, RANDOLPH, MA 02368-4104
(781) 986-4800
Mailing address
16 STATION ST, ATTLEBORO, MA 02703-2566
(508) 455-1861
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
07/13/2018
Last updated
07/13/2018
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