Provider Demographics
NPI:1447506985
Name:CASTELL, KATY BROOKE (PT)
Entity type:Individual
Prefix:
First Name:KATY
Middle Name:BROOKE
Last Name:CASTELL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KATY
Other - Middle Name:BROOKE
Other - Last Name:DOLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:708 E FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-4708
Mailing Address - Country:US
Mailing Address - Phone:301-706-9218
Mailing Address - Fax:
Practice Address - Street 1:708 E FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901-4708
Practice Address - Country:US
Practice Address - Phone:301-706-9218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-02
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
MD24073225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist