Provider Demographics
NPI:1275390619
Name:SCIANNA, ADENA
Entity Type:Individual
Prefix:
First Name:ADENA
Middle Name:
Last Name:SCIANNA
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 1:224 S RUSH ST APT 3A
Mailing Address - Street 2:
Mailing Address - City:ITASCA
Mailing Address - State:IL
Mailing Address - Zip Code:60143-2190
Mailing Address - Country:US
Mailing Address - Phone:630-940-9071
Mailing Address - Fax:
Practice Address - Street 1:224 S RUSH ST APT 3A
Practice Address - Street 2:
Practice Address - City:ITASCA
Practice Address - State:IL
Practice Address - Zip Code:60143-2190
Practice Address - Country:US
Practice Address - Phone:630-940-9071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician