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Individual

MS. TRACY BETH ANTHONY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
486 SOUTH MAIN STREET, AVRC, ANDOVER, OH 44003
(440) 293-4226
(440) 293-6079
Mailing address
4588 E LAKE RD, JAMESTOWN, PA 16134-4714
(724) 932-3527

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
02854
OH

Other

Enumeration date
08/11/2008
Last updated
08/11/2008
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