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General NPI Number Information
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NPI Number | 1427924224
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Entity Type | Individual
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Provider Name | CANDICE LAWRENCE
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Gender | Female
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Dates
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Enumeration Date | 10/17/2025
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 3500 LORAIN AVE STE 407
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City | CLEVELAND
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State | OH
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Zip | 44113-3726
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Country | US
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Telephone | 216-250-1607
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Fax |
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Provider Business Mailing Address
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Address Line | 17014 KENYON RD
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City | SHAKER HEIGHTS
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State | OH
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Zip | 44120-3741
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Country | US
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Telephone | 216-420-3956
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | C.2506808-TRNE
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License Number State | OH
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