Provider Demographics
NPI:1114436524
Name:MCCAIN, ADRIENNE KAY
Entity Type:Individual
Prefix:MS
First Name:ADRIENNE
Middle Name:KAY
Last Name:MCCAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18679 LENNANE
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48240-1748
Mailing Address - Country:US
Mailing Address - Phone:313-878-2630
Mailing Address - Fax:
Practice Address - Street 1:8623 N WAYNE RD STE 123
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-1137
Practice Address - Country:US
Practice Address - Phone:734-367-0469
Practice Address - Fax:734-367-0791
Is Sole Proprietor?:No
Enumeration Date:2017-09-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist