| Doctor Name: | ROBERT ANTHONY MACE SERRATORE |
| NPI Number: | 1164506077 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LMHC MA |
| License Number: | |
| Business Practice Address: | 40 Hob Rd Los Lunas, NM - 870317601 |
| Business Phone Number: | 5058653092 |
| Business Fax Number: | 5058657721 |
| Mailing Address: | 10801 Maness Ln Sw, ALBUQUERQUE |
| State: | NM |
| Postal Code: | 871213661 |
| Phone Number: | 5756932345 |
| Fax Number: | |
| NPI Enumeration Date: | 10/25/2006 |
| NPI Last Update Date: | 07/13/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |