Provider Demographics
NPI:1144879073
Name:DEL CASTILLO, STEPHANIE AMELIA (OTD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:AMELIA
Last Name:DEL CASTILLO
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15601 E JAMISON DR APT 323
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-4655
Mailing Address - Country:US
Mailing Address - Phone:915-227-8884
Mailing Address - Fax:
Practice Address - Street 1:13525 E 23RD AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7450
Practice Address - Country:US
Practice Address - Phone:303-344-8282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
CO0005953225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist