Individual
MISS KAVITA FABIAN SERRAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1199 DELAWARE AVE, SUITE 101, MARION, OH 43302-6475
(740) 383-2513
(740) 387-6495
Mailing address
224 PETERSON AVE, MARION, OH 43302-4541
(740) 389-4092
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP5253
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000234960
ANTHEM
OH
05
—
0135133
—
OH
01
—
46-00009
UNITED HEALTH CARE
OH
Enumeration date
11/01/2006
Last updated
07/08/2007
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