Provider Demographics
NPI:1265563050
Name:WELDY, TINA D (MS)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:D
Last Name:WELDY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58308 ANDREW DR
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:IN
Mailing Address - Zip Code:46528-8663
Mailing Address - Country:US
Mailing Address - Phone:574-534-8462
Mailing Address - Fax:574-534-8462
Practice Address - Street 1:58308 ANDREW DR
Practice Address - Street 2:
Practice Address - City:GOSHEN
Practice Address - State:IN
Practice Address - Zip Code:46528-8663
Practice Address - Country:US
Practice Address - Phone:574-534-8462
Practice Address - Fax:574-534-8462
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor