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Individual

ABIGAIL MATA CASTILLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
15140 BADGER RANCH BLVD, STE 301 & 302, WOODWAY, TX 76712
(254) 829-4787
Mailing address
1404 W 11TH ST, MCGREGOR, TX 76657-1937
(254) 420-9074

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT21150488
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
21150488
BACB
TX
Enumeration date
01/29/2021
Last updated
08/24/2023
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