Individual
MS. DIANE SPADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA., LPC
Contact information
Practice address
908 2ND ST, MENOMINEE, MI 49858-3245
(906) 864-9830
(906) 864-9831
Mailing address
908 2ND ST, MENOMINEE, MI 49858-3245
(906) 864-9830
(906) 864-9831
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401010032
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
730195
—
MI
Enumeration date
02/22/2007
Last updated
02/12/2015
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