Individual
MARIBELLE SERRANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2580 PRUDEN BLVD, SUFFOLK, VA 23434-4229
(757) 934-2363
Mailing address
2580 PRUDEN BLVD, SUFFOLK, VA 23434-4229
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202008573
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2202008573
VIRGINIA STATE LICENSE
VA
Enumeration date
11/02/2017
Last updated
11/02/2017
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