Basic Information
| Provider Information | |||||||||
| NPI: | 1447234430 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HASKINS | ||||||||
| FirstName: | CORA | ||||||||
| MiddleName: | SUE | ||||||||
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| Credential: | LLP, LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 41207 GREENSPIRE DR | ||||||||
| Address2: | |||||||||
| City: | CLINTON TOWNSHIP | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480385860 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5862603146 | ||||||||
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| Practice Location | |||||||||
| Address1: | 15945 CANAL RD | ||||||||
| Address2: | |||||||||
| City: | CLINTON TOWNSHIP | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480381610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5864162300 | ||||||||
| FaxNumber: | 5864162311 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/02/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 6401006955 | MI | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.