Provider Demographics
NPI:1114510518
Name:SINGLETON, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:SINGLETON
Suffix:
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 1:1860 GREENMORE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-3520
Mailing Address - Country:US
Mailing Address - Phone:803-552-5531
Mailing Address - Fax:
Practice Address - Street 1:1860 GREENMORE DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-3520
Practice Address - Country:US
Practice Address - Phone:803-552-5531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-16
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Single Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty