Individual
TISHA MARIE PAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
52 OLD HAMPTON LN SUITE F, HAMPTON, VA 23669
(757) 915-6857
Mailing address
52 OLD HAMPTON LN STE F, HAMPTON, VA 23669-4196
(757) 915-6817
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
09/12/2017
Last updated
09/12/2017
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