Provider Demographics
NPI:1942076047
Name:KHO, SERENE WEI YEN
Entity Type:Individual
Prefix:
First Name:SERENE WEI YEN
Middle Name:
Last Name:KHO
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 1:26 HICHBORN ST APT 23
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-2266
Mailing Address - Country:US
Mailing Address - Phone:617-943-7558
Mailing Address - Fax:
Practice Address - Street 1:GBH
Practice Address - Street 2:10 GUEST ST
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135
Practice Address - Country:US
Practice Address - Phone:617-267-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health