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General NPI Number Information
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NPI Number | 1912598137
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Entity Type | Individual
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Provider Name | GABRIEL CASTILLO BCBA
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Gender | Male
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Dates
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Enumeration Date | 01/30/2021
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Last Update Date | 07/06/2024
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Provider Practice Location Address
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Address Line | 11800 CHESTER VILLAGE DR
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City | CHESTER
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State | VA
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Zip | 23831-1782
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Country | US
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Telephone | 804-544-9044
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Fax | 804-715-4789
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Provider Business Mailing Address
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Address Line | 13000 RIVERS BEND BLVD
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City | CHESTER
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State | VA
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Zip | 23836-8632
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Country | US
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Telephone | 571-234-2033
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-21-46893
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License Number State | VA
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