Provider Demographics
NPI:1184761553
Name:HASKINS, SCOTTIE L JR (PHD)
Entity type:Individual
Prefix:DR
First Name:SCOTTIE
Middle Name:L
Last Name:HASKINS
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:WILLIE
Other - Middle Name:L
Other - Last Name:HASKINS
Other - Suffix:JR
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:COPE INC., 2701 N OKLAHOMA AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73105
Mailing Address - Country:US
Mailing Address - Phone:405-528-8686
Mailing Address - Fax:
Practice Address - Street 1:COPE INC., 2701 N OKLAHOMA AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73105
Practice Address - Country:US
Practice Address - Phone:405-528-8686
Practice Address - Fax:405-528-8692
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK261QM0801X
OKLPC 2868251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Not Answered251S00000XAgenciesCommunity/Behavioral Health