Provider Demographics
NPI:1396193470
Name:HERNANDEZ-WELCH, NELLY (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:NELLY
Middle Name:
Last Name:HERNANDEZ-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 1:306 E 92ND ST APT 2E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-5498
Mailing Address - Country:US
Mailing Address - Phone:646-853-3717
Mailing Address - Fax:
Practice Address - Street 1:306 E 92ND ST APT 2E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-5498
Practice Address - Country:US
Practice Address - Phone:646-853-3717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-30
Last Update Date:2016-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025651235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist