Basic Information
Provider Information
NPI: 1467657734
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SINGH
FirstName: ARCHNA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: OT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SINGH
OtherFirstName: ARCHNA
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 5
Mailing Information
Address1: 1100 BLYTHE BLVD
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282035814
CountryCode: US
TelephoneNumber: 7043558484
FaxNumber: 7043554231
Practice Location
Address1: 5615 GRANDHAVEN DR
Address2:  
City: DURHAM
State: NC
PostalCode: 277136123
CountryCode: US
TelephoneNumber: 8033168243
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/18/2007
LastUpdateDate: 01/08/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/08/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X6394NCY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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