Payne Behavioral Medicine

NPI 1215375746 - Psychologist - 103TC0700X

NPI Details
NPI 1215375746
Enumeration Date 06/06/2013
Last Updated 06/06/2013
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name NANETTA NANETTA
Position FOUNDER/PRESIDENT
Phone (601) 506-8735
Fax (601) 767-2747
Practice Location
4005 N STATE ST STE N
JACKSON MS, 39206-5755, US
Phone (601) 506-8735
Fax (601) 767-2747
Business Location
4005 N STATE ST STE N
JACKSON MS, 39206-5755, US
Phone (601) 506-8735
Fax (601) 767-2747
Toxanomy
Taxonomy Code 103TC0700X
License State Mississippi
License Number 48841
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According to our database, Payne Behavioral Medicine NPI is 1215375746, taxonomy code is 103TC0700X and license number is 48841, license state is located at Mississippi. Payne Behavioral Medicine physically located at 4005 N State St Ste N, Jackson MS, 39206-5755. NPI Number 1033115704 has the healthcare provider type.

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1215375746 NPI number is provided on an as is basis without warranty of any kind. 1215375746 is maintained by the National Plan & Provider Enumeration System. The contents of Payne Behavioral Medicine are for informational purposes only.