Provider Demographics
NPI:1902367311
Name:SERRANO, HELEN BANAKEN (OTRL)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:BANAKEN
Last Name:SERRANO
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37197 E STONEY RUN
Mailing Address - Street 2:
Mailing Address - City:SELBYVILLE
Mailing Address - State:DE
Mailing Address - Zip Code:19975-4325
Mailing Address - Country:US
Mailing Address - Phone:302-524-8333
Mailing Address - Fax:302-524-8891
Practice Address - Street 1:6 ELLIS ALLEY
Practice Address - Street 2:UNIT 6
Practice Address - City:SELBYVILLE
Practice Address - State:DE
Practice Address - Zip Code:19975
Practice Address - Country:US
Practice Address - Phone:302-567-1907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-28
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEU1-0001554225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist