Healthcare Provider Details

I. General information

NPI: 1619209798
Provider Name (Legal Business Name): LAURA LYNN PAYNTER P.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2010
Last Update Date: 02/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11565 PEARL RD
STRONGSVILLE OH
44136-3356
US

IV. Provider business mailing address

472 CANTERBURY LN
SAGAMORE HILLS OH
44067-4109
US

V. Phone/Fax

Practice location:
  • Phone: 440-846-0862
  • Fax:
Mailing address:
  • Phone: 440-413-3334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC 06002212
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: