Individual provider · Type 1 NPI
Ida Louisse Serraon
Speech-Language Assistant · Fort Worth, TX
NPI number
1063108314
Active
Practice location
7900 S Hulen St
Fort Worth, TX 76123-3085
Mailing address
200 Deerpath Rd
Hickory Creek, TX 75065-7508
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Speech-Language Assistant Primary | 2355S0801X | 43092 (TX) |
Speech-Language Assistant: Definition to come...
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About NPI 1063108314
Ida Louisse Serraon's National Provider Identifier is 1063108314, issued on Apr 11, 2023. The primary taxonomy on file is Speech-Language Assistant (2355S0801X), and the practice location is in Fort Worth, TX. The record was last updated on Oct 16, 2026.