Basic Information
| Provider Information | |||||||||
| NPI: | 1932137338 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SINGER | ||||||||
| FirstName: | TYRA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1019 LINN ST | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452031314 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5132337100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1019 LINN ST | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452031314 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5132337100 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2006 | ||||||||
| LastUpdateDate: | 01/27/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 247200000X | N | Technologists, Technicians & Other Technical Service Providers | Technician, Other | 1041S0200X | Y | Behavioral Health & Social Service Providers | Social Worker | School |
ID Information
| ID | Type | State | Issuer | Description | 184607 | 01 | KY | MEDICARE GROUP NUMBER | OTHER |