# SERENITY SPACE THERAPY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801484407
- **Authorized official:** ALEXANDRA VAGANOVA LMFT (OWNER)
- **Authorized official phone:** (954) 999-2320

## Contact information

- **Practice address:** 2699 STIRLING RD STE C403A, FORT LAUDERDALE, FL 33312-6564
- **Practice address phone:** (954) 999-2320
- **Mailing address:** 2699 STIRLING RD STE C403A, FORT LAUDERDALE, FL 33312-6564
- **Mailing address phone:** (954) 999-2320

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 01/08/2021
- **Last updated:** 01/08/2021