Provider Demographics
NPI:1194889659
Name:CASTILLO, ALICIA (SLP)
Entity type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 ANGELITA ST.
Mailing Address - Street 2:STE. #16
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596
Mailing Address - Country:US
Mailing Address - Phone:956-969-5777
Mailing Address - Fax:956-969-5775
Practice Address - Street 1:505 ANGELITA ST.
Practice Address - Street 2:STE. #16
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596
Practice Address - Country:US
Practice Address - Phone:956-969-5777
Practice Address - Fax:956-969-5775
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102352235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist