Provider Demographics
NPI:1285345959
Name:CLAY, TONYA M
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:M
Last Name:CLAY
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 1:22140 EUCLID AVE APT 102
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1613
Mailing Address - Country:US
Mailing Address - Phone:216-965-6931
Mailing Address - Fax:
Practice Address - Street 1:22140 EUCLID AVE APT 102
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44117-1613
Practice Address - Country:US
Practice Address - Phone:216-965-6931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPS.003770175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist