Healthcare Provider Details

I. General information

NPI: 1801435433
Provider Name (Legal Business Name): KAREN M CASTELLI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2019
Last Update Date: 12/31/2019
Certification Date: 12/31/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 RAVEN RD
STEPHENS CITY VA
22655-2473
US

IV. Provider business mailing address

211 RAVEN RD
STEPHENS CITY VA
22655-2473
US

V. Phone/Fax

Practice location:
  • Phone: 540-550-5184
  • Fax:
Mailing address:
  • Phone: 540-550-5184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0133001537
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: