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General NPI Number Information
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NPI Number | 1255687927
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Entity Type | Individual
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Provider Name | LILLIAN MICHELLE STEPHENS CASTILLE
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Gender | Female
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Dates
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Enumeration Date | 07/31/2012
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Last Update Date | 08/01/2012
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Provider Practice Location Address
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Address Line | 1029 CAPITOL AVE
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City | CROWLEY
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State | LA
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Zip | 70526
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Country | US
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Telephone | 337-788-7507
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Fax | 337-788-7757
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Provider Business Mailing Address
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Address Line | 1029 CAPITAL AVE
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City | CROWLEY
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State | LA
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Zip | 70526
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Country | US
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Telephone | 337-788-7507
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Fax | 337-788-7577
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 868
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 868
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License Number State | LA
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