Provider Demographics
NPI:1265682041
Name:WELCH, BROOKE M (AUD)
Entity Type:Individual
Prefix:
First Name:BROOKE
Middle Name:M
Last Name:WELCH
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:
Other - Last Name:PISCHKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 424
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50302-0424
Mailing Address - Country:US
Mailing Address - Phone:515-875-9925
Mailing Address - Fax:515-875-9923
Practice Address - Street 1:5950 UNIVERSITY AVE STE 265
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8233
Practice Address - Country:US
Practice Address - Phone:515-875-9450
Practice Address - Fax:515-875-9457
Is Sole Proprietor?:No
Enumeration Date:2008-09-29
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8330231H00000X
IA107562231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist