Provider Demographics
NPI:1043649502
Name:CASTILLO, RACHEL R (SLPA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:R
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:R
Other - Last Name:GONZALEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5200 E FARNESS DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-2140
Mailing Address - Country:US
Mailing Address - Phone:520-232-2021
Mailing Address - Fax:520-232-2553
Practice Address - Street 1:1830 E BROADWAY BLVD
Practice Address - Street 2:SUITE 124-143
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-5966
Practice Address - Country:US
Practice Address - Phone:520-232-2021
Practice Address - Fax:520-232-2553
Is Sole Proprietor?:No
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8272235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist