Provider Demographics
NPI:1083466445
Name:DENNING-KRAS, CADENCE OLIVIA
Entity Type:Individual
Prefix:
First Name:CADENCE
Middle Name:OLIVIA
Last Name:DENNING-KRAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CADENCE
Other - Middle Name:OLIVIA
Other - Last Name:KRAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:391 KENT ST APT C
Mailing Address - Street 2:
Mailing Address - City:EAST ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62024-1664
Mailing Address - Country:US
Mailing Address - Phone:815-419-7137
Mailing Address - Fax:
Practice Address - Street 1:411 EDWARDSVILLE RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:IL
Practice Address - Zip Code:62294-1339
Practice Address - Country:US
Practice Address - Phone:314-275-0506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILRBT-24-338033106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician