Provider Demographics
NPI:1811083900
Name:BADE, AMY MARIE (EDD LIC PSYCHOLOGIST)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:MARIE
Last Name:BADE
Suffix:
Gender:F
Credentials:EDD LIC PSYCHOLOGIST
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:29 WEST 8TH STREET
Mailing Address - Street 2:SUITE 240
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423
Mailing Address - Country:US
Mailing Address - Phone:616-396-1433
Mailing Address - Fax:616-396-9643
Practice Address - Street 1:29 WEST 8TH STREET
Practice Address - Street 2:SUITE 240
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423
Practice Address - Country:US
Practice Address - Phone:616-396-1433
Practice Address - Fax:616-396-9643
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI6301008394103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist