Individual
MRS. TRACI STALLWORTH-ESTRADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S, ED
Contact information
Practice address
12501 BRITTON DR, CLEVELAND, OH 44120-1008
(216) 415-9532
Mailing address
12501 BRITTON DR, CLEVELAND, OH 44120-1008
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
372600000X
Adult Companion
Primary
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
09/30/2024
Last updated
09/30/2024
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