Provider Demographics
NPI:1558858563
Name:STRATTON, SERINA BLAIR
Entity Type:Individual
Prefix:MRS
First Name:SERINA
Middle Name:BLAIR
Last Name:STRATTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6620 STATE ROUTE 94 E
Mailing Address - Street 2:
Mailing Address - City:SEDALIA
Mailing Address - State:KY
Mailing Address - Zip Code:42079-9514
Mailing Address - Country:US
Mailing Address - Phone:270-227-8478
Mailing Address - Fax:
Practice Address - Street 1:6620 STATE ROUTE 94 E
Practice Address - Street 2:
Practice Address - City:SEDALIA
Practice Address - State:KY
Practice Address - Zip Code:42079-9514
Practice Address - Country:US
Practice Address - Phone:270-227-8478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-16
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker