Provider Demographics
NPI:1366270571
Name:SERENITY SOUL PATHWAY PSYCHIATRY INC
Entity type:Organization
Organization Name:SERENITY SOUL PATHWAY PSYCHIATRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DOSS
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:614-664-3335
Mailing Address - Street 1:5312 ARYSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-9424
Mailing Address - Country:US
Mailing Address - Phone:614-664-3356
Mailing Address - Fax:
Practice Address - Street 1:5312 ARYSHIRE DR
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-9424
Practice Address - Country:US
Practice Address - Phone:614-664-3356
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty