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General NPI Number Information
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NPI Number | 1114303260
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Entity Type | Individual
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Provider Name | TENNIEL SINGLETON-THOMAS
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Gender | Female
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Dates
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Enumeration Date | 07/30/2015
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Last Update Date | 07/30/2015
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Provider Practice Location Address
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Address Line | 533 TROTTERS LN SE
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City | CONYERS
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State | GA
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Zip | 30094-4189
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Country | US
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Telephone | 678-661-1803
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 83446
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City | CONYERS
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State | GA
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Zip | 30013-9445
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Country | US
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Telephone | 404-838-6326
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number | 058510994
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License Number State | GA
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