Provider Demographics
NPI:1104456102
Name:SINGLETON, LAJUNE (BOARD CERTIFIED HEAL)
Entity type:Individual
Prefix:
First Name:LAJUNE
Middle Name:
Last Name:SINGLETON
Suffix:
Gender:F
Credentials:BOARD CERTIFIED HEAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16701 MELFORD BLVD
Mailing Address - Street 2:STE# 400
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-0076
Mailing Address - Country:US
Mailing Address - Phone:301-836-1327
Mailing Address - Fax:
Practice Address - Street 1:16701 MELFORD BLVD STE 400
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-4411
Practice Address - Country:US
Practice Address - Phone:301-836-1327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-19
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD8350171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD84-4882154Medicaid
MD84-4882154OtherCIGNA
MD844882154OtherAETNA