Provider Demographics
NPI:1033664065
Name:HAGHPASSAND, SIMA III
Entity Type:Individual
Prefix:
First Name:SIMA
Middle Name:
Last Name:HAGHPASSAND
Suffix:III
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7716 PIONEER DR
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-9462
Mailing Address - Country:US
Mailing Address - Phone:734-915-8510
Mailing Address - Fax:
Practice Address - Street 1:7716 PIONEER DR
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-9462
Practice Address - Country:US
Practice Address - Phone:734-915-8510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-19
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801057111101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health