Healthcare Provider Details

I. General information

NPI: 1427693837
Provider Name (Legal Business Name): BRIANNA TERRANOVA PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRIANNA ZUMDAHL

II. Dates (important events)

Enumeration Date: 11/08/2019
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 W GOLF RD STE 30
ARLINGTON HEIGHTS IL
60005-3923
US

IV. Provider business mailing address

415 W GOLF RD STE 30
ARLINGTON HEIGHTS IL
60005-3923
US

V. Phone/Fax

Practice location:
  • Phone: 224-323-6620
  • Fax:
Mailing address:
  • Phone: 224-323-6620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071.010169
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: