Provider Demographics
NPI:1700010105
Name:SCHUEN, PAM (MA, LLP, IMH-E(IV-C))
Entity Type:Individual
Prefix:
First Name:PAM
Middle Name:
Last Name:SCHUEN
Suffix:
Gender:F
Credentials:MA, LLP, IMH-E(IV-C)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3356 DUNNS RDG
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49006-6402
Mailing Address - Country:US
Mailing Address - Phone:269-760-5400
Mailing Address - Fax:
Practice Address - Street 1:3285 122ND AVE
Practice Address - Street 2:PO DRAWER 130
Practice Address - City:ALLEGAN
Practice Address - State:MI
Practice Address - Zip Code:49010-9511
Practice Address - Country:US
Practice Address - Phone:269-673-6617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301012890103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1700010105Medicaid