Provider Demographics
NPI:1508261868
Name:WELICH, LAUREN MARIE (MT-BC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:MARIE
Last Name:WELICH
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3916 WYNDHAM RIDGE DR
Mailing Address - Street 2:#102
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-6175
Mailing Address - Country:US
Mailing Address - Phone:216-409-5269
Mailing Address - Fax:
Practice Address - Street 1:3916 WYNDHAM RIDGE DR
Practice Address - Street 2:102
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-6175
Practice Address - Country:US
Practice Address - Phone:216-409-5269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-29
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist