Provider Demographics
NPI:1487804860
Name:SINGLETON, VANITY
Entity type:Individual
Prefix:
First Name:VANITY
Middle Name:
Last Name:SINGLETON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 WOODWARD ST
Mailing Address - Street 2:APT 204
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-8951
Mailing Address - Country:US
Mailing Address - Phone:512-665-6631
Mailing Address - Fax:
Practice Address - Street 1:12912 HILL COUNTRY BLVD
Practice Address - Street 2:SUITE F220
Practice Address - City:BEE CAVES
Practice Address - State:TX
Practice Address - Zip Code:78738-6328
Practice Address - Country:US
Practice Address - Phone:512-665-6631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT043439225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist