# MRS. TRACI STALLWORTH-ESTRADA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1508684481
- **Gender:** F
- **Credential:** M.S, ED

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 172A00000X | Driver | — | NULL | — |
| 372600000X | Adult Companion | — | NULL | Yes |
| 372600000X | Adult Companion | — | — | Yes |
| 385HR2060X | Child Intellectual and/or Developmental Disabilities Respite Care | — | NULL | — |
| 385HR2065X | Child Physical Disabilities Respite Care | — | NULL | — |

## Other

- **Enumeration date:** 09/30/2024
- **Last updated:** 09/30/2024