Provider Demographics
NPI:1083489975
Name:WELCH, NEAH RAQUEL-TAYLOR
Entity Type:Individual
Prefix:
First Name:NEAH
Middle Name:RAQUEL-TAYLOR
Last Name:WELCH
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 1:4305 NORWOOD AVE APT 49
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95838-2665
Mailing Address - Country:US
Mailing Address - Phone:925-375-7262
Mailing Address - Fax:
Practice Address - Street 1:4305 NORWOOD AVE APT 49
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95838-2665
Practice Address - Country:US
Practice Address - Phone:925-375-7262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health