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General NPI Number Information
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NPI Number | 1346790946
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Entity Type | Individual
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Provider Name | YARITZA RIVERA SERRANO MA. SLP
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Gender | Female
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Dates
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Enumeration Date | 10/06/2016
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 146 1ST ST
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City | BAXLEY
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State | GA
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Zip | 31513-8654
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Country | US
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Telephone | 407-307-6182
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Fax | 229-506-7222
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Provider Business Mailing Address
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Address Line | 1516 RICARDO ST
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City | VALDOSTA
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State | GA
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Zip | 31601-3334
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Country | US
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Telephone | 407-307-6182
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Fax | 220-506-7222
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SLP010826
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SA16419
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License Number State | FL
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