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Individual
TRACY CLARK
Active
Individual
TRACY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP 10535
OH
374U00000X
Home Health Aide
—
OH
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
11/03/2014
Last updated
11/17/2020
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