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Edwin Payne, LPC

Counselor, Professional in Jackson, MI. Individual provider (NPI-1).

NPI number1629599485
StatusActive
Last updated in NPPESJul 2, 2017

Details

NPI
1629599485
Entity type
Individual (NPI-1)
Name
Edwin Payne
Credential
LPC
Sex
Male
Sole proprietor
No
Enumeration date
Jul 2, 2017
Last updated
Jul 2, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YP2500X Counselor, Professional6401011227MIYes

Practice location

2019 4th St
Jackson, MI 49203-3555

Phone 734-719-0193

Mailing address

2019 4th St
Jackson, MI 49203-3555

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