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NPI Code Detail

MEDICARE: MISS DEANNA IVY PAYNE

MEDICARE: MISS DEANNA IVY PAYNE
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
1106S00000XBehavior Technician
2103K00000XBehavior Analyst1-21-55115

General Provider Information

NPI Number : 1659808889
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS DEANNA IVY PAYNE
Provider Business Mailing Address
First Line : 723 SANDRA ST
Second Line :
City : GARNER
State : NC
Zip : 27529-2700
Country : US
Telephone Number : 919-429-0678
Fax Number :
Provider Business Practice Location Address
First Line : 210 TALS ROCK WAY STE 3
Second Line :
City : CARY
State : NC
Zip : 27519-1919
Country : US
Telephone Number : 919-745-8892
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2017
Last Update Date : 11/12/2021

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Directions to “ MISS DEANNA IVY PAYNE ” Practice Location

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