Jaquarius Tyrone Payne

NPI #1861075780 in Southlake, Texas

Provider Information

NPI Number: 1861075780
Entity Type: Individual
Name: Jaquarius Tyrone Payne
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Apr 29, 2021
Last Updated: Apr 29, 2021

Practice Location

Address: 2104 GREENBRIAR DR
City: Southlake
State: Texas
ZIP Code: 76092-8355
Phone: (817) 442-9022

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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