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NPI 1417096397

NPI 1417096397 : ADELLE MCLAIN CADIEUX PHD : GRAND RAPIDS, MI

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General NPI Number Information
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    NPI Number           |    1417096397
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    Entity Type          |    Individual 
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    Provider Name        |    ADELLE MCLAIN CADIEUX PHD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/06/2007
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    Last Update Date     |    02/19/2021
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Provider Practice Location Address
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    Address Line         |    35 MICHIGAN ST NE STE 1800 
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    City                 |    GRAND RAPIDS
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    State                |    MI
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    Zip                  |    49503-2568
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    Country              |    US
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    Telephone            |    616-391-7999
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    Fax                  |    616-391-8750
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Provider Business Mailing Address
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    Address Line         |    100 MICHIGAN ST NE MC 845
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    City                 |    GRAND RAPIDS
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    State                |    MI
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    Zip                  |    49503-2560
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    103TC0700X
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    Taxonomy Name        |    Clinical Psychologist
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    License Number       |    6301011616
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    License Number State |    MI
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