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General NPI Number Information
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NPI Number | 1104714252
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Entity Type | Individual
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Provider Name | DEANNA SERIO
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Gender | Female
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Dates
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Enumeration Date | 06/26/2025
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 10420 S EASTERN AVE STE 110
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City | HENDERSON
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State | NV
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Zip | 89052-4197
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Country | US
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Telephone | 702-547-0006
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Fax |
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Provider Business Mailing Address
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Address Line | 155 BROKEN TEE DR
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City | HENDERSON
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State | NV
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Zip | 89074-8324
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Country | US
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Telephone | 702-281-9727
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 2009301380
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License Number State | NV
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