Provider Demographics
NPI:1558704957
Name:GERSH, HARTSON, PAYNE & ASSOCIATES, PC
Entity Type:Organization
Organization Name:GERSH, HARTSON, PAYNE & ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:319-338-9960
Mailing Address - Street 1:373 SCOTT CT STE A
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-3904
Mailing Address - Country:US
Mailing Address - Phone:319-338-9960
Mailing Address - Fax:
Practice Address - Street 1:373 SCOTT CT STE A
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-3904
Practice Address - Country:US
Practice Address - Phone:319-338-9960
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-16
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty