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General NPI Number Information
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NPI Number | 1922283423
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Entity Type | Individual
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Provider Name | ERICA LAQUONIA SINGLETON RN
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Gender | Female
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Dates
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Enumeration Date | 01/02/2008
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Last Update Date | 01/02/2008
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Provider Practice Location Address
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Address Line | 1654 HIGHWAY 1 S
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City | GREENVILLE
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State | MS
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Zip | 38701-7108
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Country | US
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Telephone | 662-332-7022
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Fax | 662-332-7022
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Provider Business Mailing Address
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Address Line | 2350 BLUEBIRD DR
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City | GREENVILLE
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State | MS
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Zip | 38701-8127
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Country | US
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Telephone | 662-332-7820
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Fax | 662-332-7022
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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 | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 07186736
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License Number State | MS
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