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General NPI Number Information
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NPI Number | 1780292136
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Entity Type | Individual
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Provider Name | MS. CASLEA JOY SERINA
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Gender | Female
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Dates
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Enumeration Date | 07/21/2020
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Last Update Date | 11/14/2023
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Provider Practice Location Address
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Address Line | 544 4TH AVE STE 102
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City | FAIRBANKS
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State | AK
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Zip | 99701-4714
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Country | US
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Telephone | 907-450-9962
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Fax |
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Provider Business Mailing Address
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Address Line | 3875 GEIST RD STE 402
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City | FAIRBANKS
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State | AK
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Zip | 99709-3564
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Country | US
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Telephone | 907-450-9962
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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 | 2183165
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License Number State | AK
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 150512
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License Number State | AK
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