Healthcare Provider Details

I. General information

NPI: 1598626764
Provider Name (Legal Business Name): DR. MOLLY CORY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 W MICHIGAN AVE
YPSILANTI MI
48197-5550
US

IV. Provider business mailing address

25882 ORCHARD LAKE RD STE L-1
FARMINGTON HILLS MI
48336-1269
US

V. Phone/Fax

Practice location:
  • Phone: 313-444-2630
  • Fax:
Mailing address:
  • Phone: 313-444-2630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6301019373
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: