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General NPI Number Information
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NPI Number | 1649774357
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Entity Type | Individual
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Provider Name | ANDREW MICHAEL SCHAAD
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Gender | Male
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Dates
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Enumeration Date | 03/19/2018
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Last Update Date | 03/19/2018
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Provider Practice Location Address
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Address Line | 23965 NOVI RD STE 130
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City | NOVI
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State | MI
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Zip | 48375-0204
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Country | US
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Telephone | 248-946-4664
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Fax |
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Provider Business Mailing Address
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Address Line | 14130 SHADYWOOD DR APT C-40
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City | PLYMOUTH
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State | MI
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Zip | 48170-3125
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Country | US
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Telephone | 419-235-2981
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6401015718
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License Number State | MI
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