Provider Demographics
NPI:1619697992
Name:SINGLETON, WANDA
Entity Type:Individual
Prefix:
First Name:WANDA
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 1:5002 SAIL ROCK PL
Mailing Address - Street 2:
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-0907
Mailing Address - Country:US
Mailing Address - Phone:928-391-9132
Mailing Address - Fax:
Practice Address - Street 1:3814 LILLIAN WOOD AVE
Practice Address - Street 2:
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-2075
Practice Address - Country:US
Practice Address - Phone:928-391-9132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach