Individual
ELISABETH ERIN PAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
215 SE JACKSON ST, ROSEBURG, OR 97470-3341
(541) 464-6660
Mailing address
1036 SE DOUGLAS AVE., ROOM CH105A, ROSEBURG, OR 97470
(541) 391-2636
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366697690
—
OR
Enumeration date
05/05/2022
Last updated
05/05/2022
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