Provider Demographics
NPI:1093028144
Name:GRACE-SINGLETON, DENISE YVONNE (BA, MA)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:YVONNE
Last Name:GRACE-SINGLETON
Suffix:
Gender:F
Credentials:BA, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 AMORY ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-2310
Mailing Address - Country:US
Mailing Address - Phone:617-921-4359
Mailing Address - Fax:617-524-2809
Practice Address - Street 1:304 AMORY ST
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-2310
Practice Address - Country:US
Practice Address - Phone:617-921-4359
Practice Address - Fax:617-524-2809
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-19
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA272420125103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily