Provider Demographics
NPI:1518677079
Name:WASHBURN, HALEIGH ELIZABETH JOY (MSW)
Entity Type:Individual
Prefix:
First Name:HALEIGH
Middle Name:ELIZABETH JOY
Last Name:WASHBURN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:HALEIGH
Other - Middle Name:ELIZABETH JOY
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2153 FOX HILL DR APT 12
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-5233
Mailing Address - Country:US
Mailing Address - Phone:330-926-6260
Mailing Address - Fax:
Practice Address - Street 1:1 GENESYS PKWY
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-8065
Practice Address - Country:US
Practice Address - Phone:810-606-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-24
Last Update Date:2022-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851114981104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker