Provider Demographics
NPI:1770891236
Name:CASTLE, BRYANNE ELLEN (MA)
Entity type:Individual
Prefix:MRS
First Name:BRYANNE
Middle Name:ELLEN
Last Name:CASTLE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 145
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO BEND
Mailing Address - State:VT
Mailing Address - Zip Code:05842-0145
Mailing Address - Country:US
Mailing Address - Phone:802-533-2129
Mailing Address - Fax:
Practice Address - Street 1:265 RTE 16
Practice Address - Street 2:
Practice Address - City:GREENSBORO BEND
Practice Address - State:VT
Practice Address - Zip Code:05842-8958
Practice Address - Country:US
Practice Address - Phone:802-533-2129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-18
Last Update Date:2010-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No251S00000XAgenciesCommunity/Behavioral Health