Healthcare Provider Details

I. General information

NPI: 1669398087
Provider Name (Legal Business Name): CLARICE MICHELE MORONI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5561 EAGLES LANDING DR
OREGON OH
43616-1124
US

IV. Provider business mailing address

5561 EAGLES LANDING DR
OREGON OH
43616-1124
US

V. Phone/Fax

Practice location:
  • Phone: 419-764-9286
  • Fax:
Mailing address:
  • Phone: 419-764-9286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: