Provider Demographics
NPI:1255958013
Name:JENKINS-PAYNE, LAUREN ASHLEY
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:ASHLEY
Last Name:JENKINS-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 1:279 S TAFT CT # 10EAST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-9515
Mailing Address - Country:US
Mailing Address - Phone:601-542-3204
Mailing Address - Fax:
Practice Address - Street 1:279 S TAFT CT # 10EAST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-9515
Practice Address - Country:US
Practice Address - Phone:601-542-3204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-28
Last Update Date:2020-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician