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NPI Code Detail

MEDICARE: DR. ASHLEY R SERRANO M.A., M.S., PH.D.

MEDICARE: DR. ASHLEY R SERRANO M.A., M.S., PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistLP5792MN
2103TC0700XClinical Psychologist651ND

General Provider Information

NPI Number : 1093940355
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ASHLEY R SERRANO M.A., M.S., PH.D.
Provider Business Mailing Address
First Line : PO BOX 5074
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57117-5074
Country : US
Telephone Number : 605-328-6585
Fax Number :
Provider Business Practice Location Address
First Line : 1800 E INTERSTATE AVE
Second Line :
City : BISMARCK
State : ND
Zip : 58503-1399
Country : US
Telephone Number : 701-323-8800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2009
Last Update Date : 02/19/2025

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