Provider Demographics
NPI:1447234430
Name:HASKINS, CORA SUE (LLP, LPC)
Entity type:Individual
Prefix:
First Name:CORA
Middle Name:SUE
Last Name:HASKINS
Suffix:
Gender:F
Credentials:LLP, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41207 GREENSPIRE DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-5860
Mailing Address - Country:US
Mailing Address - Phone:586-260-3146
Mailing Address - Fax:
Practice Address - Street 1:15945 CANAL RD
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-1610
Practice Address - Country:US
Practice Address - Phone:586-416-2300
Practice Address - Fax:586-416-2311
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401006955101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional