Provider Demographics
NPI:1720864101
Name:SINGH, THERESA J (PTA)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:J
Last Name:SINGH
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:372 CHERRYFIELD DR
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46385-8422
Mailing Address - Country:US
Mailing Address - Phone:219-716-4141
Mailing Address - Fax:
Practice Address - Street 1:1451 MORTHLAND DR
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46385-6357
Practice Address - Country:US
Practice Address - Phone:219-286-3882
Practice Address - Fax:219-703-3703
Is Sole Proprietor?:No
Enumeration Date:2023-09-01
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant