Provider Demographics
NPI:1790802734
Name:MCCADNEY, VANESSA JANE (FAODP)
Entity Type:Individual
Prefix:MISS
First Name:VANESSA
Middle Name:JANE
Last Name:MCCADNEY
Suffix:
Gender:F
Credentials:FAODP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3840 FAIRVIEW
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48214-2112
Mailing Address - Country:US
Mailing Address - Phone:313-331-8990
Mailing Address - Fax:313-331-7365
Practice Address - Street 1:3840 FAIRVIEW
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48214-2112
Practice Address - Country:US
Practice Address - Phone:313-331-8990
Practice Address - Fax:313-331-7563
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)