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Individual

DR. PRISCILLA WADE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D

Contact information

Practice address
4123 OKEMOS RD STE 15, OKEMOS, MI 48864-2818
(517) 336-7366
(517) 336-0808
Mailing address
PO BOX 4455, EAST LANSING, MI 48826-4455
(517) 336-7366
(517) 336-0808

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301007011
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
03626
VALUE OPTIONS
MI
01
063276
CONNECTICUT GENERAL
MI
01
1016708
MCLAREN
MI
01
11291411
BLUE CROSS TRUST
MI
01
228936000
MAGELLAN
MI
01
68OC34678
BLUE CROSS BLUE SHIELD
MI
01
78357
CONNECTICUT GENERAL
MI
01
A029412
VENDOR NUMBER
MI
01
MI5228936
BLUE CARE NETWORK
MI
01
R67036
MAGELLAN
MI
Enumeration date
01/03/2007
Last updated
07/04/2020
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