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General NPI Number Information
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NPI Number | 1396913604
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Entity Type | Individual
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Provider Name | L. STEPHANIE SERRA LMFT
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Gender | Female
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Dates
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Enumeration Date | 02/20/2008
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Last Update Date | 10/29/2010
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Provider Practice Location Address
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Address Line | 564 N IDAHO RD STE 9
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City | APACHE JUNCTION
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State | AZ
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Zip | 85119-4003
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Country | US
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Telephone | 480-474-5500
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Fax | 480-983-2800
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Provider Business Mailing Address
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Address Line | PO BOX 3160
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City | APACHE JUNCTION
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State | AZ
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Zip | 85117-4115
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Country | US
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Telephone | 480-474-5500
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Fax | 480-983-2800
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT-10326
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License Number State | AZ
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