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General NPI Number Information
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NPI Number | 1891231809
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Entity Type | Individual
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Provider Name | WILDA CASTRO
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Gender | Female
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Dates
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Enumeration Date | 01/13/2017
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Last Update Date | 02/24/2017
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Provider Practice Location Address
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Address Line | 2501 N GREEN VALLEY PKWY BUILDING D SUITE 116 D
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City | HENDERSON
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State | NV
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Zip | 89014-0273
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Country | US
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Telephone | 702-605-2766
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Fax | 702-938-9056
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Provider Business Mailing Address
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Address Line | 5600 E RUSSELL RD UNIT 2117
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City | LAS VEGAS
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State | NV
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Zip | 89122-8014
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Country | US
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Telephone | 702-724-1677
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MI0779
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License Number State | NV
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