Provider Demographics
NPI:1700641784
Name:PAYNE, ALEANA CAROL (RBT)
Entity Type:Individual
Prefix:
First Name:ALEANA
Middle Name:CAROL
Last Name:PAYNE
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1551 COUNTY ROAD 119
Mailing Address - Street 2:
Mailing Address - City:BRYCEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32009-1719
Mailing Address - Country:US
Mailing Address - Phone:190-463-1647
Mailing Address - Fax:
Practice Address - Street 1:1551 COUNTY ROAD 119
Practice Address - Street 2:
Practice Address - City:BRYCEVILLE
Practice Address - State:FL
Practice Address - Zip Code:32009-1719
Practice Address - Country:US
Practice Address - Phone:904-631-6427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-327584106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician