Healthcare Provider Details

I. General information

NPI: 1457084048
Provider Name (Legal Business Name): TRACY WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2022
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2023 SUNSET BLVD
STEUBENVILLE OH
43952-1349
US

IV. Provider business mailing address

1141 SMITH AVE SW
CANTON OH
44706-1458
US

V. Phone/Fax

Practice location:
  • Phone: 740-283-3347
  • Fax:
Mailing address:
  • Phone: 234-804-1003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: