Individual
DEL'QWANIA LI'CHELLE PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10019 FOREST GREEN BLVD, LOUISVILLE, KY 40223-5119
(502) 893-1380
Mailing address
2739 BROWNSBORO RD APT 8, LOUISVILLE, KY 40206-1270
(502) 601-2006
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/16/2023
Last updated
11/16/2023
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