MEDICARE: DR. JESSICA LYNN SINGLETON PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC2200X	Clinical Child & Adolescent Psychologist	294681-2501	UT
2	103TS0200X	School Psychologist		UT

General Provider Information

NPI Number	:	1093831372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSICA LYNN SINGLETON PH.D.

Provider Business Mailing Address
First Line	:	PSC 41 BOX 4869
Second Line	:
City	:	APO
State	:	AE
Zip	:	09464-0049
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	UNIT 5210 BOX 230
Second Line	:
City	:	APO
State	:	AE
Zip	:	09461-0230
Country	:	US
Telephone Number	:	16-385-2226
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	02/04/2010

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