Provider Demographics
NPI:1699043125
Name:SERABIAN, CHRISTI LEIGH
Entity Type:Individual
Prefix:MRS
First Name:CHRISTI
Middle Name:LEIGH
Last Name:SERABIAN
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:ROSS CLINIC
Mailing Address - Street 2:271 FT RICHARDSON AVE BLDG 1007
Mailing Address - City:GOODFELLOW AIR FORCE BASE
Mailing Address - State:TX
Mailing Address - Zip Code:76908
Mailing Address - Country:US
Mailing Address - Phone:325-654-3122
Mailing Address - Fax:
Practice Address - Street 1:271 FT RICHARDSON AVE BLDG 1007
Practice Address - Street 2:
Practice Address - City:GOODFELLOW
Practice Address - State:TX
Practice Address - Zip Code:76908
Practice Address - Country:US
Practice Address - Phone:325-654-3122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-12
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1450843101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health