Provider Demographics
NPI:1740595578
Name:CASTILLO, MONICA (OTR)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:CASTILLO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 N FLOYD RD
Mailing Address - Street 2:#9
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-4243
Mailing Address - Country:US
Mailing Address - Phone:972-470-5855
Mailing Address - Fax:
Practice Address - Street 1:1112 N FLOYD RD
Practice Address - Street 2:#9
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-4243
Practice Address - Country:US
Practice Address - Phone:972-470-5855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109559225X00000X, 225XF0002X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XF0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistFeeding, Eating & Swallowing
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics