Provider Demographics
NPI:1619251659
Name:CASTRO, MONICA P (MS SLP)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:P
Last Name:CASTRO
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5945 CLIFFDALE RD STE 1111
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-2101
Mailing Address - Country:US
Mailing Address - Phone:910-229-3951
Mailing Address - Fax:910-565-3053
Practice Address - Street 1:5945 CLIFFDALE RD STE 1111
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-2101
Practice Address - Country:US
Practice Address - Phone:910-229-3951
Practice Address - Fax:910-565-3053
Is Sole Proprietor?:No
Enumeration Date:2011-10-10
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11733235Z00000X
FLSA13380235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist