Individual
AMBRA PAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22001 FAIRMOUNT BLVD, SHAKER HEIGHTS, OH 44118-4819
(216) 932-2800
Mailing address
3015 BROOKDALE AVE, PARMA, OH 44134-1955
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
S.1600815
OH
Other
Enumeration date
10/14/2016
Last updated
10/14/2016
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