Provider Demographics
NPI:1336469493
Name:SERRANO-CORREA, NEREIDA (PHD)
Entity Type:Individual
Prefix:DR
First Name:NEREIDA
Middle Name:
Last Name:SERRANO-CORREA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 CALLE VERMONT
Mailing Address - Street 2:URB. SAN GERARDO
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-3414
Mailing Address - Country:US
Mailing Address - Phone:787-226-5002
Mailing Address - Fax:
Practice Address - Street 1:H29 CALLE 2
Practice Address - Street 2:EXT. VILLA RICA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-5029
Practice Address - Country:US
Practice Address - Phone:787-785-6611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-10
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR808101YP2500X
PR1790103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling