Individual
BREONNA NICOLE PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1320 MAIN ST STE 300, COLUMBIA, SC 29201-3266
(877) 418-2978
(866) 500-2186
Mailing address
709 ELDERBERRY LN, COLUMBIA, SC 29229-6836
(814) 384-5609
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
SC
Other
Enumeration date
05/09/2024
Last updated
05/09/2024
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