Provider Demographics
NPI:1184355166
Name:PAYNTER, EMMA
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:PAYNTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 E COLORADO BLVD UNIT 3007
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-1932
Mailing Address - Country:US
Mailing Address - Phone:724-218-3338
Mailing Address - Fax:
Practice Address - Street 1:80 SPINNAKER DRIVE
Practice Address - Street 2:203
Practice Address - City:HALIFAX
Practice Address - State:NS
Practice Address - Zip Code:B3N 3B5
Practice Address - Country:CA
Practice Address - Phone:724-218-3338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-21
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT4274225X00000X
CA18262225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist