Healthcare Provider Details

I. General information

NPI: 1164022273
Provider Name (Legal Business Name): TRACY REID INHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2020
Last Update Date: 04/22/2024
Certification Date: 04/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3518 W 25TH ST
CLEVELAND OH
44109-1951
US

IV. Provider business mailing address

2538 KEMPER RD APT 17
SHAKER HEIGHTS OH
44120-1215
US

V. Phone/Fax

Practice location:
  • Phone: 216-741-2241
  • Fax:
Mailing address:
  • Phone: 216-396-6992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberM.2400382-TRNE
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License NumberPERMANENT
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: