Provider Demographics
NPI:1134770878
Name:SCARA, ELENA
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:SCARA
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 1:26405 N 57TH DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85083-1239
Mailing Address - Country:US
Mailing Address - Phone:602-384-0180
Mailing Address - Fax:
Practice Address - Street 1:26405 N 57TH DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85083-1239
Practice Address - Country:US
Practice Address - Phone:602-384-0180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-24
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health