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General NPI Number Information
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NPI Number | 1114350006
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Entity Type | Individual
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Provider Name | CAROLYN K SERRANO
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Gender | Female
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Dates
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Enumeration Date | 08/14/2013
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Last Update Date | 06/10/2014
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Provider Practice Location Address
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Address Line | CALLE ALMENDRA G18 URB ESTANCIA DE LA CEIBA
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City | HATILLO
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State | PR
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Zip | 00659
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Country | US
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Telephone | 787-454-2356
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Fax | 787-898-7094
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Provider Business Mailing Address
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Address Line | PO BOX 141832
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City | ARECIBO
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State | PR
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Zip | 00614-1832
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Country | US
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Telephone | 787-454-2356
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Fax | 787-898-7094
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 4811
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License Number State | PR
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