Individual
JACQUELINE CASTILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4004 CARLISLE BLVD NE STE C-3, ALBUQUERQUE, NM 87107-4565
(505) 717-7227
Mailing address
4612 HUYANA DR NW, ALBUQUERQUE, NM 87120-5597
(505) 358-8910
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0181221
NM
Other
Enumeration date
11/06/2018
Last updated
12/11/2019
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