Provider Demographics
NPI:1629763503
Name:SEREFF, CLARISSA CHRISTINE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CLARISSA
Middle Name:CHRISTINE
Last Name:SEREFF
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 MONTVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80631-5344
Mailing Address - Country:US
Mailing Address - Phone:605-390-6264
Mailing Address - Fax:
Practice Address - Street 1:1605 MONTVIEW BLVD
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-5344
Practice Address - Country:US
Practice Address - Phone:605-390-6264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COSLP.0004530235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist