Provider Demographics
NPI:1821335191
Name:WELCH, MINDA (MED)
Entity Type:Individual
Prefix:
First Name:MINDA
Middle Name:
Last Name:WELCH
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 ROSEBEN CT
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-8360
Mailing Address - Country:US
Mailing Address - Phone:775-770-4899
Mailing Address - Fax:
Practice Address - Street 1:200 S VIRGINIA ST FL 8
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89501-2403
Practice Address - Country:US
Practice Address - Phone:877-360-7045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator