Provider Demographics
NPI:1316073562
Name:CABLE, MARSHA JACQUELINE (MA, LLP, SPADA)
Entity type:Individual
Prefix:MS
First Name:MARSHA
Middle Name:JACQUELINE
Last Name:CABLE
Suffix:
Gender:F
Credentials:MA, LLP, SPADA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1316 WEBSTER ST NW
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49504-2954
Mailing Address - Country:US
Mailing Address - Phone:616-451-8018
Mailing Address - Fax:
Practice Address - Street 1:3949 SPARKS DR SE
Practice Address - Street 2:SUITE 103
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-6110
Practice Address - Country:US
Practice Address - Phone:616-957-5850
Practice Address - Fax:616-957-5853
Is Sole Proprietor?:No
Enumeration Date:2007-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301007965103TA0400X, 103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral