Provider Demographics
NPI:1568533818
Name:CASTILLO, CHRISTINE L (PHD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:L
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:L
Other - Last Name:FRENCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:600H EDEN ROAD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601
Mailing Address - Country:US
Mailing Address - Phone:717-397-1400
Mailing Address - Fax:717-509-4066
Practice Address - Street 1:6300 HARRY HINES BLVD
Practice Address - Street 2:CHILDREN'S MEDICAL CENTER DALLAS, NEUROPSYCHOLOGY
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-5259
Practice Address - Country:US
Practice Address - Phone:214-456-5872
Practice Address - Fax:214-456-2220
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2015-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33096103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist