Individual
DANIELLE SHAUNTE PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 GWEE SHUT RD, SILETZ, OR 97380-2036
(541) 444-1030
Mailing address
PO BOX 320, SILETZ, OR 97380-0320
(541) 444-9623
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
17-CRM-160
OR
Other
Enumeration date
09/26/2017
Last updated
09/26/2017
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