Provider Demographics
NPI:1366675407
Name:WELCH, MARIA V (MS, CCC)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:V
Last Name:WELCH
Suffix:
Gender:F
Credentials:MS, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1713 MARCEE LN
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-4647
Mailing Address - Country:US
Mailing Address - Phone:847-922-5902
Mailing Address - Fax:
Practice Address - Street 1:1713 MARCEE LN
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-4647
Practice Address - Country:US
Practice Address - Phone:847-922-5902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-24
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146003362235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist