Provider Demographics
NPI:1689365116
Name:SINGH, LACEY DAWN
Entity Type:Individual
Prefix:MRS
First Name:LACEY
Middle Name:DAWN
Last Name:SINGH
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 1:109 PAUL AVE
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-5213
Mailing Address - Country:US
Mailing Address - Phone:580-819-0384
Mailing Address - Fax:
Practice Address - Street 1:109 PAUL AVE
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-5213
Practice Address - Country:US
Practice Address - Phone:580-819-0384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator