Provider Demographics
NPI:1063638120
Name:WELTZIEN, JOAN (EDD)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:WELTZIEN
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 WESLAYAN ST STE 255
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-5751
Mailing Address - Country:US
Mailing Address - Phone:713-621-6665
Mailing Address - Fax:713-552-9522
Practice Address - Street 1:3000 WESLAYAN ST STE 255
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-5751
Practice Address - Country:US
Practice Address - Phone:713-621-6665
Practice Address - Fax:713-552-9522
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23011103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist