Provider Demographics
NPI:1235483355
Name:WELCH, ERIN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:WELCH
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42536 HAYES RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-6766
Mailing Address - Country:US
Mailing Address - Phone:586-286-9644
Mailing Address - Fax:
Practice Address - Street 1:42536 HAYES RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48038-6766
Practice Address - Country:US
Practice Address - Phone:586-286-9644
Practice Address - Fax:586-286-9647
Is Sole Proprietor?:No
Enumeration Date:2012-10-29
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI12106923235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI235Z00000XOtherSPEECH AND LANGUAGE PATHOLOGIST