Provider Demographics
NPI:1922210368
Name:STCLAIR, TRACY ONNA
Entity type:Individual
Prefix:MS
First Name:TRACY
Middle Name:ONNA
Last Name:STCLAIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:831 HEMLOCK ST NW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44647-8817
Mailing Address - Country:US
Mailing Address - Phone:330-833-7706
Mailing Address - Fax:
Practice Address - Street 1:831 HEMLOCK ST NW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44647-8817
Practice Address - Country:US
Practice Address - Phone:330-833-7706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2634126374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide