Provider Demographics
NPI:1467860122
Name:WELCH, AMANDA
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:WELCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9103 WOODMORE CENTER DR
Mailing Address - Street 2:207
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-1653
Mailing Address - Country:US
Mailing Address - Phone:202-710-6880
Mailing Address - Fax:301-583-1362
Practice Address - Street 1:9103 WOODMORE CENTER DR
Practice Address - Street 2:207
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-1653
Practice Address - Country:US
Practice Address - Phone:202-710-6880
Practice Address - Fax:301-583-1362
Is Sole Proprietor?:No
Enumeration Date:2014-07-25
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health