Provider Demographics
NPI:1992911812
Name:SINGLETARY, JAIME CANDACE (OTRL)
Entity type:Individual
Prefix:MISS
First Name:JAIME
Middle Name:CANDACE
Last Name:SINGLETARY
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 LANTERN WOOD DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30079-6800
Mailing Address - Country:US
Mailing Address - Phone:404-664-2956
Mailing Address - Fax:
Practice Address - Street 1:431 LANTERN WOOD DR
Practice Address - Street 2:
Practice Address - City:SCOTTDALE
Practice Address - State:GA
Practice Address - Zip Code:30079-6800
Practice Address - Country:US
Practice Address - Phone:404-664-2956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 12650225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist