| Diane L Payne Phd Pa | |
|
3111 Springbank Ln Suite I Charlotte NC 28226-3372 | |
| (704) 540-0625 | |
| Not Available |
| Full Name | Diane L Payne Phd Pa |
|---|---|
| Speciality | Psychologist |
| Location | 3111 Springbank Ln, Charlotte, North Carolina |
| Authorized Official Name and Position | Diane L Payne (OWNER) |
| Authorized Official Contact | 7042223429 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diane L Payne Phd Pa 3111 Springbank Ln Suite I Charlotte NC 28226-3372 Ph: (704) 540-0625 | Diane L Payne Phd Pa 3111 Springbank Ln Suite I Charlotte NC 28226-3372 Ph: (704) 540-0625 |
| NPI Number | 1588681142 |
|---|---|
| Provider Enumeration Date | 07/17/2006 |
| Last Update Date | 01/04/2008 |
| Medicare PECOS PAC ID | 0941371959 |
|---|---|
| Medicare Enrollment ID | O20080619000107 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588681142 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 1615 (North Carolina) | Primary |
| Provider Name | Diane L Payne |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942468228 PECOS PAC ID: 1850385998 Enrollment ID: I20041021001007 |
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