Provider Demographics
NPI:1639886682
Name:SINGLETON, HATTIE (BCABA)
Entity Type:Individual
Prefix:
First Name:HATTIE
Middle Name:
Last Name:SINGLETON
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:ALTAVISTA
Mailing Address - State:VA
Mailing Address - Zip Code:24517-1839
Mailing Address - Country:US
Mailing Address - Phone:434-941-1100
Mailing Address - Fax:
Practice Address - Street 1:66 TIMBEROAK CT
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-3459
Practice Address - Country:US
Practice Address - Phone:434-515-0877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0134000350106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty