Provider Demographics
NPI:1932668019
Name:PAYNE, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:PAYNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 HIGHLAND RD APT 284
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-6513
Mailing Address - Country:US
Mailing Address - Phone:318-751-1265
Mailing Address - Fax:
Practice Address - Street 1:5151 HIGHLAND RD APT 284
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-6513
Practice Address - Country:US
Practice Address - Phone:318-751-1265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst