Tracy Clark, MA, CCC-SLP
Speech-Language Pathologist, in Niles, OH. Individual provider (NPI-1).
NPI number1528463593
StatusActive
Last updated in NPPESNov 17, 2020
Details
- NPI
- 1528463593
- Entity type
- Individual (NPI-1)
- Name
- Tracy Clark
- Credential
- MA, CCC-SLP
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Nov 3, 2014
- Certification date
- Nov 17, 2020
- Last updated
- Nov 17, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235Z00000X | Speech-Language Pathologist, | SP 10535 | OH | Yes |
| 374U00000X | Home Health Aide | – | OH | |
| 385HR2060X | Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | – | – |
Practice location
6000 Youngstown-Warren RdTcesc
Niles, OH 44446
Phone 330-505-2800
Mailing address
10749 Bartholomew RdChagrin Falls, OH 44023-9084
Other practice locations
10749 Bartholomew Rd
Chagrin Falls, OH 44023-9084
Chagrin Falls, OH 44023-9084
Phone 440-785-1437
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All 50 Speech-Language Pathologist providers in Niles · All 1,027 providers in Niles
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