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NPI Code Detail

MEDICARE: SARAH KIECANA

MEDICARE: SARAH KIECANA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1255105110
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH KIECANA
Provider Business Mailing Address
First Line : 1001 N MAIN ST
Second Line :
City : HARRISBURG
State : IL
Zip : 62946-1065
Country : US
Telephone Number : 312-550-0811
Fax Number :
Provider Business Practice Location Address
First Line : 1001 N MAIN ST
Second Line :
City : HARRISBURG
State : IL
Zip : 62946-1065
Country : US
Telephone Number : 312-550-0811
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2023
Last Update Date : 11/10/2023

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Directions to “ SARAH KIECANA ” Practice Location

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