Provider Demographics
NPI:1679072706
Name:WELSH, JOLYN P
Entity Type:Individual
Prefix:
First Name:JOLYN
Middle Name:P
Last Name:WELSH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JOLYN
Other - Middle Name:
Other - Last Name:KISIDAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1140 HOLLY SPRINGS RD STE 111
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-9634
Mailing Address - Country:US
Mailing Address - Phone:919-285-2157
Mailing Address - Fax:
Practice Address - Street 1:1140 HOLLY SPRINGS RD STE 111
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-9634
Practice Address - Country:US
Practice Address - Phone:919-285-2157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-05
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL013265235Z00000X
NC13583235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist