MEDICARE: RECHELLE 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
1	106S00000X	Behavior Technician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RBT-18-61733	OTHER		BACB REGISTRATION NUMBER

General Provider Information

NPI Number	:	1881225332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RECHELLE PAYNE

Provider Business Mailing Address
First Line	:	3351 ASPEN GROVE DR STE 350
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-2912
Country	:	US
Telephone Number	:	615-721-5921
Fax Number	:

Provider Business Practice Location Address
First Line	:	700 ABBOTT DR UNIT 2
Second Line	:
City	:	BROOMALL
State	:	PA
Zip	:	19008-4323
Country	:	US
Telephone Number	:	484-444-2285
Fax Number	:

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

Provider Enumeration Date	:	02/03/2020
Last Update Date	:	02/03/2020

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Directions to “ RECHELLE PAYNE ” Practice Location

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