Provider Demographics
NPI:1194204982
Name:CASTELLANOS, JACKELINE CHELSEA
Entity type:Individual
Prefix:
First Name:JACKELINE
Middle Name:CHELSEA
Last Name:CASTELLANOS
Suffix:
Gender:F
Credentials:
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 1356
Mailing Address - Street 2:
Mailing Address - City:HIDALGO
Mailing Address - State:TX
Mailing Address - Zip Code:78557-1356
Mailing Address - Country:US
Mailing Address - Phone:956-219-8052
Mailing Address - Fax:
Practice Address - Street 1:908 W. EDINBURG AVE, SUITE B
Practice Address - Street 2:
Practice Address - City:ELSA
Practice Address - State:TX
Practice Address - Zip Code:78543-1769
Practice Address - Country:US
Practice Address - Phone:956-262-1037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant