Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 294681-2501 | UT |
N | 103TS0200X | School Psychologist | UT |
NPI | 1093831372 |
---|---|
Provider Name | Dr. Jessica Lynn Singleton |
First Address | Apo, AE 09464-0049 |
Second Address | Apo, AE 09461-0230 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2007 |
Last Update Date | 04/02/2010 |