Provider Demographics
NPI:1093323156
Name:PAYNE, TAMMEY DAVIS (PH D PSY)
Entity Type:Individual
Prefix:DR
First Name:TAMMEY
Middle Name:DAVIS
Last Name:PAYNE
Suffix:
Gender:F
Credentials:PH D PSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 AMBERSWEET WAY # 310
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33897-8418
Mailing Address - Country:US
Mailing Address - Phone:407-747-7628
Mailing Address - Fax:863-438-7383
Practice Address - Street 1:1423 MERRIMACK LANE
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837
Practice Address - Country:US
Practice Address - Phone:407-747-7628
Practice Address - Fax:863-438-7383
Is Sole Proprietor?:No
Enumeration Date:2020-07-15
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral