Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 6301007965 | MI |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 6301007965 | MI |
NPI | 1316073562 |
---|---|
Provider Name | Ms. Marsha Jacqueline Cable |
First Address | Grand Rapids, MI 49504-2954 |
Second Address | Grand Rapids, MI 49546-6110 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2007 |
Last Update Date | 08/07/2007 |