| NPI | 1609945831 |
|---|---|
| Professional Name | MARIE A SHADE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ID LCPC44) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: ID LCPC44) |
| 101YP2500X Counselor Professional (Licence: ID LCPC44) | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2007-07-08 |