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NPI Code Detail

MEDICARE: LISA PAYNE ED.S

MEDICARE: LISA PAYNE ED.S
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TS0200XSchool PsychologistOH1427489OH

General Provider Information

NPI Number : 1780009654
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA PAYNE ED.S
Provider Business Mailing Address
First Line : 775 RATHMELL RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43207-4737
Country : US
Telephone Number : 614-491-8044
Fax Number :
Provider Business Practice Location Address
First Line : 775 RATHMELL RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43207-4737
Country : US
Telephone Number : 614-491-8044
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2014
Last Update Date : 02/28/2014

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Directions to “ LISA PAYNE ED.S” Practice Location

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