Individual
BROOKE DIANE PAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, CPSC
Contact information
Practice address
20 W BANK ST, PETERSBURG, VA 23803-3279
(804) 862-8002
Mailing address
20 W BANK ST, PETERSBURG, VA 23803-3279
(804) 862-8002
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904017532
VA
Other
Enumeration date
12/05/2024
Last updated
12/05/2024
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