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NPI Code Detail

MEDICARE: MARIEL CASTANEDA

MEDICARE: MARIEL CASTANEDA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianRBT-20-136633

General Provider Information

NPI Number : 1467025924
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIEL CASTANEDA
Provider Business Mailing Address
First Line : 5695 KING CENTRE DR
Second Line : UNIT 101
City : ALEXANDRIA
State : VA
Zip : 22315-5746
Country : US
Telephone Number : 703-680-9527
Fax Number :
Provider Business Practice Location Address
First Line : 5695 KING CENTRE DR
Second Line : UNIT 101
City : ALEXANDRIA
State : VA
Zip : 22315-5746
Country : US
Telephone Number : 703-680-9527
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2021
Last Update Date : 07/22/2021

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Directions to “ MARIEL CASTANEDA ” Practice Location

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