MEDICARE: AMANDA MARIE SERRANO LMFT

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
1	106H00000X	Marriage & Family Therapist	MI1076	NV
2	106H00000X	Marriage & Family Therapist	4242	NV

General Provider Information

NPI Number	:	1215411756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA MARIE SERRANO LMFT

Provider Business Mailing Address
First Line	:	10620 SOUTHERN HIGHLANDS PKWY STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-4372
Country	:	US
Telephone Number	:	702-219-5596
Fax Number	:

Provider Business Practice Location Address
First Line	:	10620 SOUTHERN HIGHLANDS PKWY STE 110-776
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-4371
Country	:	US
Telephone Number	:	702-389-7937
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2018
Last Update Date	:	11/21/2024

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