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General NPI Number Information
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NPI Number | 1881780419
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Entity Type | Individual
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Provider Name | ALICE MARIE CASTLEBERRY PSYD
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Gender | Female
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 12/01/2016
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Provider Practice Location Address
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Address Line | 327 EARL GARRETT ST
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City | KERRVILLE
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State | TX
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Zip | 78028-4514
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Country | US
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Telephone | 830-522-2547
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2536 PO BOX 561
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City | ATHENS
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State | TX
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Zip | 75751-7536
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Country | US
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Telephone | 830-928-5299
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 32485
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License Number State | TX
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