Provider Demographics
NPI:1669958906
Name:CASTELLANO, VENESSA
Entity type:Individual
Prefix:
First Name:VENESSA
Middle Name:
Last Name:CASTELLANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3522 SPICEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78542-2417
Mailing Address - Country:US
Mailing Address - Phone:956-292-5564
Mailing Address - Fax:
Practice Address - Street 1:871 OLD ALICE RD STE 100
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-8269
Practice Address - Country:US
Practice Address - Phone:956-292-5564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-18
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX364612355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant