NPI | 1114367018 |
---|---|
Former Name | KELLIE MICHELLE WELCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 231H00000X Audiologist (Licence: FL AY1165) |
Additional Taxonomies | 231H00000X Audiologist (Licence: IA 000748) |
237600000X Audiologist-Hearing Aid Fitter (Licence: IA 001046) | |
Enumeration Date | 2013-06-25 |
Last Update Date | 2013-06-25 |