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Individual

DR. CHADWICK J SHADE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
5955 ZEAMER AVENUE, 3RD MDG, ELMENDORF AFB, AK 99506
(907) 580-2181
Mailing address
5955 ZEAMER AVENUE, 3RD MDG, ELMENDORF AFB, AK 99506
(907) 580-2181

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY0091
MO

Other

Enumeration date
04/23/2010
Last updated
04/23/2010
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