Provider Demographics
NPI:1801133061
Name:SINGLETON, KALENA KIDD (LMT)
Entity type:Individual
Prefix:MRS
First Name:KALENA
Middle Name:KIDD
Last Name:SINGLETON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38520 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LADY LAKE
Mailing Address - State:FL
Mailing Address - Zip Code:32159-3910
Mailing Address - Country:US
Mailing Address - Phone:352-552-6340
Mailing Address - Fax:
Practice Address - Street 1:38520 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159-3910
Practice Address - Country:US
Practice Address - Phone:352-552-6340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA46932225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist