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General NPI Number Information
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NPI Number | 1649611716
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Entity Type | Individual
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Provider Name | MISS ISIS B. CASILLAS
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Gender | Female
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Dates
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Enumeration Date | 07/17/2013
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 9415 SW 72ND ST STE 131
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City | MIAMI
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State | FL
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Zip | 33173-5492
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Country | US
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Telephone | 305-662-6448
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Fax |
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Provider Business Mailing Address
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Address Line | 8980 W FLAGLER ST APT. 108
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City | MIAMI
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State | FL
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Zip | 33174-3963
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Country | US
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Telephone | 786-280-8505
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Fax |
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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 | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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