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General NPI Number Information
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NPI Number | 1487466629
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Entity Type | Individual
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Provider Name | ELIZABETH PAYNE
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Gender | Female
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Dates
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Enumeration Date | 01/24/2025
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 26695 CENTER RIDGE RD
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City | WESTLAKE
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State | OH
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Zip | 44145-4023
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Country | US
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Telephone | 440-835-3737
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Fax |
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Provider Business Mailing Address
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Address Line | 1335 STRASSNER DR
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City | BRENTWOOD
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State | MO
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Zip | 63144-1872
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Country | US
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Telephone | 317-503-0782
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA007172
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License Number State | OH
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