Provider Demographics
NPI:1689992216
Name:SINGLETARY, TIFFANY MARIE (PT)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:MARIE
Last Name:SINGLETARY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 ESSINGTON RD
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-2859
Mailing Address - Country:US
Mailing Address - Phone:815-744-4770
Mailing Address - Fax:815-744-4772
Practice Address - Street 1:920 ESSINGTON RD
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-2859
Practice Address - Country:US
Practice Address - Phone:815-744-4770
Practice Address - Fax:815-744-4772
Is Sole Proprietor?:No
Enumeration Date:2010-05-06
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.009081225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist