Individual
MAKAYLA DANIELLE CASTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
628 LAKE ST NE, WISE, VA 24293-7919
(276) 328-8017
Mailing address
628 LAKE ST NE, WISE, VA 24293-7919
(276) 328-8017
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202010415
VA
235Z00000X
Speech-Language Pathologist
2204000762
VA
Other
Enumeration date
07/22/2021
Last updated
06/13/2022
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