Provider Demographics
NPI:1265249197
Name:FRIEDERS, GIANNA
Entity type:Individual
Prefix:
First Name:GIANNA
Middle Name:
Last Name:FRIEDERS
Suffix:
Gender:U
Credentials:
Other - Prefix:MR
Other - First Name:JAX
Other - Middle Name:MICHAEL
Other - Last Name:FRIEDERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:337 S ELMWOOD DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506
Mailing Address - Country:US
Mailing Address - Phone:630-991-1768
Mailing Address - Fax:
Practice Address - Street 1:337 S ELMWOOD DR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-6050
Practice Address - Country:US
Practice Address - Phone:630-991-1768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-13
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician