Provider Demographics
NPI:1962174623
Name:CASTILLO, VALERIA GRACIELA (CCC-SLP, MS)
Entity type:Individual
Prefix:
First Name:VALERIA
Middle Name:GRACIELA
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:CCC-SLP, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7840 FM 1960 RD E STE 401
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-2258
Mailing Address - Country:US
Mailing Address - Phone:281-548-2458
Mailing Address - Fax:
Practice Address - Street 1:13350 WOODFOREST BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015-2826
Practice Address - Country:US
Practice Address - Phone:832-386-4404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-01
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX121683235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist