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General NPI Number Information
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NPI Number | 1669171237
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Entity Type | Organization
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Legal Business Name | SILOE MIND AND WELLNESS SERVICES, PLLC
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Dates
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Enumeration Date | 03/02/2023
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Last Update Date | 03/02/2023
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Provider Practice Location Address
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Address Line | 10664 VISTA DEL SOL DR STE A
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City | EL PASO
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State | TX
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Zip | 79935-4554
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Country | US
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Telephone | 915-479-2754
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Fax |
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Provider Business Mailing Address
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Address Line | 3456 CHICKASAW DR
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City | EL PASO
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State | TX
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Zip | 79936-1261
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/ OWNER
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Name | MARCO POLO CASTORENA
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Credential | LPC
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Telephone | 915-479-2754
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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