Healthcare Provider Details

I. General information

NPI: 1902730401
Provider Name (Legal Business Name): TEARIKKA PAYNE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3319 ARGENT BLVD
RIDGELAND SC
29936-3266
US

IV. Provider business mailing address

3319 ARGENT BLVD
RIDGELAND SC
29936-3266
US

V. Phone/Fax

Practice location:
  • Phone: 240-840-1888
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-533268
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: