Individual
SERA SISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4951 44TH AVE S APT 308, FARGO, ND 58104-4204
(701) 936-9494
Mailing address
4951 44TH AVE S APT 308, FARGO, ND 58104-4204
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
08/22/2025
Last updated
08/22/2025
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