Provider Demographics
NPI:1831922038
Name:MCENTEE, ARIANA MARIAH
Entity type:Individual
Prefix:
First Name:ARIANA
Middle Name:MARIAH
Last Name:MCENTEE
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 1:14200 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60827-2516
Mailing Address - Country:US
Mailing Address - Phone:773-470-7892
Mailing Address - Fax:
Practice Address - Street 1:14200 S STATE ST
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:IL
Practice Address - Zip Code:60827-2516
Practice Address - Country:US
Practice Address - Phone:773-470-7892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician