Provider Demographics
NPI:1235302688
Name:WELCH, CYNTHIA ARLENE (CBA)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ARLENE
Last Name:WELCH
Suffix:
Gender:F
Credentials:CBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 OLIVIA ST
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-6420
Mailing Address - Country:US
Mailing Address - Phone:305-292-0716
Mailing Address - Fax:
Practice Address - Street 1:902 OLIVIA ST
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-6420
Practice Address - Country:US
Practice Address - Phone:305-292-0716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-07
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6935052 96Medicaid
FL6935052 98Medicaid