Provider Demographics
NPI:1295087104
Name:WELKER, ANDREA
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:WELKER
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:PO BOX 176
Mailing Address - Street 2:
Mailing Address - City:CHEROKEE VILLAGE
Mailing Address - State:AR
Mailing Address - Zip Code:72525-0176
Mailing Address - Country:US
Mailing Address - Phone:870-856-3337
Mailing Address - Fax:
Practice Address - Street 1:2012
Practice Address - Street 2:2012 HIGHWAY 62/412
Practice Address - City:HARDY
Practice Address - State:AR
Practice Address - Zip Code:72542
Practice Address - Country:US
Practice Address - Phone:870-257-3336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-03
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR104100000X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker