MEDICARE: MS. JILL ROBIN PAYNE L.P.C.

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
1	101YP2500X	Professional Counselor	17697	TX

General Provider Information

NPI Number	:	1215131305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JILL ROBIN PAYNE L.P.C.

Provider Business Mailing Address
First Line	:	10206 ELLA LEE LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77042-2940
Country	:	US
Telephone Number	:	281-658-6925
Fax Number	:	713-977-0833

Provider Business Practice Location Address
First Line	:	10206 ELLA LEE LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77042-2940
Country	:	US
Telephone Number	:	281-658-6925
Fax Number	:	713-977-0833

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2007
Last Update Date	:	07/08/2007

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