Provider Demographics
NPI:1265472252
Name:WELCH, ALISON K (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:K
Last Name:WELCH
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11305 SWAN CANYON RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-3539
Mailing Address - Country:US
Mailing Address - Phone:858-693-9064
Mailing Address - Fax:858-578-7485
Practice Address - Street 1:11305 SWAN CANYON RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-3539
Practice Address - Country:US
Practice Address - Phone:858-693-9064
Practice Address - Fax:858-578-7485
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2009-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP5368235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist