Individual
MAI LEE PAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
365 S INDUSTRIAL BLVD, CALHOUN, GA 30701-3075
(706) 624-3000
(706) 624-3001
Mailing address
365 S INDUSTRIAL BLVD, CALHOUN, GA 30701-3075
(706) 624-3000
(706) 624-3001
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT003214
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000891338B
—
GA
01
—
10037594
AMERIGROUP
GA
Enumeration date
06/22/2005
Last updated
10/22/2015
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