Individual
TARA PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LPC
Contact information
Practice address
303 HICKORY STREET, THIBODAUX, LA 70301
(985) 228-4887
Mailing address
303 HICKORY ST, THIBODAUX, LA 70301-2011
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6221
LA
Other
Enumeration date
08/18/2017
Last updated
08/18/2017
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