Individual
TAMIKA R PAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS, SST
Contact information
Practice address
2925 RUSSELL ST, DETROIT, MI 48207-4825
(313) 396-5300
Mailing address
2925 RUSSELL ST, DETROIT, MI 48207-4825
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
382363235
—
MI
Enumeration date
03/05/2013
Last updated
03/05/2013
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