Individual
DEANA PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
83 HIGHWAY 49, VIBURNUM, MO 65566-1001
(573) 244-5555
Mailing address
PO BOX 706, VIBURNUM, MO 65566-0706
(573) 244-5555
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2005022527
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
497220806
—
MO
Enumeration date
07/03/2006
Last updated
02/20/2020
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