Doctor Name: | AUDREY SUSAN SERAZIO |
NPI Number: | 1730450321 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | |
Business Practice Address: | 134 W Main St Ste 12 Trinidad, CO - 810822600 |
Business Phone Number: | 7198464061 |
Business Fax Number: | 7198464073 |
Mailing Address: | 134 W. Main Ste 12, TRINIDAD |
State: | CO |
Postal Code: | 81082 |
Phone Number: | 7198464061 |
Fax Number: | 7198464073 |
NPI Enumeration Date: | 01/13/2012 |
NPI Last Update Date: | 01/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |