Provider Demographics
NPI:1700255312
Name:WELCH, ERIN ADAMS (MA, SLP-CCC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:ADAMS
Last Name:WELCH
Suffix:
Gender:F
Credentials:MA, SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 COLONIAL CIR
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32176-5403
Mailing Address - Country:US
Mailing Address - Phone:386-290-8008
Mailing Address - Fax:
Practice Address - Street 1:39 COLONIAL CIR
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32176-5403
Practice Address - Country:US
Practice Address - Phone:386-290-8008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-24
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 5764235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist