MEDICARE: MS. EDITH E SERRANO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1821259078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. EDITH E SERRANO

Provider Business Mailing Address
First Line	:	2750 S DURANGO DR
Second Line	:	#2042
City	:	LAS VEGAS
State	:	NV
Zip	:	89117
Country	:	US
Telephone Number	:	702-203-1395
Fax Number	:

Provider Business Practice Location Address
First Line	:	2750 S DURANGO DR
Second Line	:	APT 2042
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2644
Country	:	US
Telephone Number	:	702-203-1395
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2008
Last Update Date	:	06/20/2008

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Directions to “ MS. EDITH E SERRANO ” Practice Location

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