Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 2923 | TN |
NPI | 1043490030 |
---|---|
Provider Name | Ms. Mary E Payne |
First Address | Nashville, TN 37209-4822 |
Second Address | Franklin, TN 37067-6456 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2007 |
Last Update Date | 26/10/2009 |