Individual
DOMINIQUE RENEE PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
STUDENT
Contact information
Practice address
4455 E 12TH AVE, DENVER, CO 80220-2415
(720) 982-8571
Mailing address
4455 E 12TH AVE, DENVER, CO 80220-2415
(720) 982-8571
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/12/2019
Last updated
06/09/2019
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