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General NPI Number Information
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NPI Number | 1154451185
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Entity Type | Individual
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Provider Name | DEBORAH W SERENIUS RD
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Gender | Female
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 5540 FAR HILLS AVE STE 108
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City | DAYTON
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State | OH
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Zip | 45429-2227
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Country | US
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Telephone | 937-586-7644
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Fax | 937-660-4575
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Provider Business Mailing Address
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Address Line | 5540 FAR HILLS AVE STE 108
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City | DAYTON
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State | OH
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Zip | 45429-2227
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Country | US
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Telephone | 937-586-7644
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Fax | 937-660-4575
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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 | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | LD-4735
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | L4735
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License Number State | OH
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